CAROLYN M GIANNELLI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

NOT RENEWED

Business

First Name

CAROLYN M

Last Name

GIANNELLI

Suffix

DDS

Business Name

CAROLYN M GIANNELLI DDS

Original Issue Date

11/18/1991

Effective Date

04/16/2010

Expiration Date

09/30/2012

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012