MARY ELIZABETH DI LISIO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

NOT RENEWED

Business

Title

DMD

First Name

MARY

Middle

ELIZABETH

Last Name

DI LISIO

Business Name

MARY ELIZABETH DI LISIO DMD

Original Issue Date

07/10/2020

Effective Date

10/15/2021

Expiration Date

09/30/2024

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025