ANDREW T BRACCI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

Last Name

BRACCI

Suffix

DMD

Business Name

ANDREW T BRACCI DMD

Original Issue Date

09/09/2008

Effective Date

09/09/2008

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009