ERIN C GIACOMINI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

NOT RENEWED

Business

First Name

ERIN C

Last Name

GIACOMINI

Suffix

DMD

Business Name

ERIN C GIACOMINI DMD

Original Issue Date

09/12/1994

Effective Date

09/12/1994

Expiration Date

09/30/1996

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005