RAFFAELE C AMBROSINO 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

RAFFAELE

Middle

Last Name

AMBROSINO

Business Name

RAFFAELE C AMBROSINO

Original Issue Date

08/09/1999

Effective Date

10/15/2021

Expiration Date

09/30/2024

City

WESTCHESTER

State

Zip

60154

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025