HAZEL M SANTIAGO-MACANIP DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

First Name

HAZEL

Middle

Last Name

SANTIAGO-MACANIP

Suffix

DDS

Business Name

HAZEL M SANTIAGO-MACANIP DDS

Original Issue Date

08/21/2001

Effective Date

08/23/2012

Expiration Date

09/30/2015

City

BOLINGBROOK

State

Zip

60490

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016