SAM R CIMMARUSTI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

SAM R

Last Name

CIMMARUSTI

Suffix

DDS

Business Name

SAM R CIMMARUSTI DDS

Original Issue Date

03/19/1986

Effective Date

03/19/1986

Expiration Date

09/30/1988

City

ZION

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005