RALPH F MADONNA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

NOT RENEWED

Business

First Name

RALPH

Middle

Last Name

MADONNA

Suffix

DDS

Business Name

RALPH F MADONNA DDS

Original Issue Date

01/01/1998

Effective Date

10/01/2009

Expiration Date

09/30/2012

City

WOOD DALE

State

Zip

60191

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012