CATHRYN A SANSOUCI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

NOT RENEWED

Business

Title

DDS

First Name

CATHRYN

Middle

Last Name

SANSOUCI

Business Name

CATHRYN A SANSOUCI DDS

Original Issue Date

05/21/1991

Effective Date

05/08/2018

Expiration Date

09/30/2018

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018