SAMUEL GREGORY BENANTI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****32

License Status

NOT RENEWED

Business

First Name

SAMUEL GREGORY

Last Name

BENANTI

Suffix

DMD

Business Name

SAMUEL GREGORY BENANTI DMD

Original Issue Date

09/24/1987

Effective Date

09/24/1987

Expiration Date

09/30/2000

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005