MICHAEL STEPHEN BORZELLO DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

INACTIVE

Business

First Name

MICHAEL STEPHEN

Last Name

BORZELLO

Suffix

DDS

Business Name

MICHAEL STEPHEN BORZELLO DDS

Original Issue Date

04/22/1982

Effective Date

08/10/2015

Expiration Date

09/30/2018

City

EUREKA

State

Zip

61530

County

WOODFORD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2018