JERRILYN M MUSACHIA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

JERRILYN M

Last Name

MUSACHIA

Business Name

JERRILYN M MUSACHIA

Original Issue Date

05/13/1987

Effective Date

05/13/1987

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/17/2005