MICHAEL THADDEUS COLLETTI Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****66

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

THADDEUS

Last Name

COLLETTI

Business Name

MICHAEL THADDEUS COLLETTI

Original Issue Date

09/21/1984

Effective Date

06/25/2024

Expiration Date

09/30/2027

City

LOMBARD

State

Zip

60148

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/25/2024