SAM MICHAEL CICCARELLI DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

ACTIVE

Business

First Name

SAM MICHAEL

Last Name

CICCARELLI

Suffix

DDS

Business Name

SAM MICHAEL CICCARELLI DDS

Original Issue Date

01/01/1998

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2024