GERALD VISCONTI 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

GERALD

Last Name

VISCONTI

Business Name

GERALD VISCONTI

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005