ANTOINETTE MARIO PETTITT DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

ACTIVE

Business

First Name

ANTOINETTE

Middle

MARIO

Last Name

PETTITT

Suffix

DDS

Business Name

ANTOINETTE MARIO PETTITT DDS

Original Issue Date

07/28/1981

Effective Date

08/28/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60601

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/28/2024