AXENTE A BUCSA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****87

License Status

NOT RENEWED

Business

First Name

AXENTE A

Last Name

BUCSA

Business Name

AXENTE A BUCSA

Original Issue Date

08/24/1990

Effective Date

08/24/1990

Expiration Date

09/30/1994

City

CHICAGO

State

Zip

60660

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005