VITTORIA MADIA PONTARELLI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

NOT RENEWED

Business

First Name

VITTORIA

Middle

MADIA

Last Name

PONTARELLI

Suffix

DDS

Business Name

VITTORIA MADIA PONTARELLI DDS

Original Issue Date

06/07/1999

Effective Date

06/07/1999

Expiration Date

09/30/2002

City

LINCONWOOD

State

Zip

60712

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005