CHARLES A AMENTA JR DDS

Business Entity
NOT RENEWED

Dentist

LICENSED DENTIST CONTROLLED SUBSTANCE

31*****92

NOT RENEWED

N

CHARLES A

AMENTA JR

DDS

CHARLES A AMENTA JR DDS

01/01/1998

09/30/2004

ELK GROVE VILLAGE

IL

60007

COOK

II III IV V

N

10/17/2005