JOHN DUGAN IACULLI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

DUGAN

Last Name

IACULLI

Business Name

JOHN DUGAN IACULLI

Original Issue Date

01/14/2009

Effective Date

09/28/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012