MARISA RUGINO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

Title

DMD

First Name

MARISA

Last Name

RUGINO

Business Name

MARISA RUGINO DMD

Original Issue Date

06/03/2020

Effective Date

06/03/2020

Expiration Date

01/31/2022

City

LA GRANGE

State

Zip

60525

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/09/2022