GARY ANTHONY CAROLLO Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

CANCELLED

Business

First Name

GARY ANTHONY

Last Name

CAROLLO

Business Name

GARY ANTHONY CAROLLO

Original Issue Date

04/06/1989

Effective Date

04/06/1989

Expiration Date

09/30/1992

City

MORRIS

State

Zip

60450

County

GRUNDY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005