ANTHONY LAVACCA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****14

License Status

NOT RENEWED

Business

First Name

ANTHONY

Last Name

LAVACCA

Suffix

DMD

Business Name

ANTHONY LAVACCA DMD

Original Issue Date

05/05/2005

Effective Date

10/21/2015

Expiration Date

09/30/2018

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018