GIANCARLO COUCH Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****33

License Status

ACTIVE

Business

First Name

GIANCARLO

Last Name

COUCH

Business Name

GIANCARLO COUCH

Original Issue Date

10/22/2018

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/30/2024