HENRY E VICIOSO DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

ACTIVE

Business

First Name

HENRY E

Last Name

VICIOSO

Suffix

DDS

Business Name

HENRY E VICIOSO DDS

Original Issue Date

09/03/1991

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

SHOREWOOD

State

Zip

60431

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024