PAUL J MASUICCA DDS 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

PAUL J

Last Name

MASUICCA

Suffix

DDS

Business Name

PAUL J MASUICCA DDS

Original Issue Date

08/14/1998

Effective Date

08/14/1998

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60638

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005