AXENTE A BUCSA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

First Name

AXENTE A

Last Name

BUCSA

Business Name

AXENTE A BUCSA

Original Issue Date

04/10/1991

Effective Date

04/10/1991

Expiration Date

09/30/1992

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005