GARY JAMES PELLIZZARO DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

INACTIVE

Business

First Name

GARY JAMES

Last Name

PELLIZZARO

Suffix

DMD

Business Name

GARY JAMES PELLIZZARO DMD

Original Issue Date

01/01/1998

Effective Date

09/05/2018

Expiration Date

09/30/2021

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/05/2018