JEROME MICHAEL COLLETTI DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

CANCELLED

Business

First Name

JEROME MICHAEL

Last Name

COLLETTI

Suffix

DDS

Business Name

JEROME MICHAEL COLLETTI DDS

Original Issue Date

06/16/1976

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

SUGAR GROVE

State

Zip

60554

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2009