ELIANE FOSSATTI GONCALVES DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

NOT RENEWED

Business

Title

DDS

First Name

ELIANE

Last Name

FOSSATTI GONCALVES

Business Name

ELIANE FOSSATTI GONCALVES DDS

Original Issue Date

07/20/2020

Effective Date

10/04/2021

Expiration Date

09/30/2024

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025