MARIO MICHAEL MAGNELIA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

First Name

MARIO MICHAEL

Last Name

MAGNELIA

Suffix

DDS

Business Name

MARIO MICHAEL MAGNELIA DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

DURAND

State

Zip

61024

County

WINNEBAGO

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

10/13/2005