MICHAEL J SCUMACI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

JOSEPH

Last Name

SCUMACI

Business Name

MICHAEL J SCUMACI

Original Issue Date

04/02/1987

Effective Date

04/02/1987

Expiration Date

09/30/1988

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005