MADALYN ELISE VACCA DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

ACTIVE

Business

Title

DMD

First Name

MADALYN

Middle

ELISE

Last Name

VACCA

Business Name

MADALYN ELISE VACCA DMD

Original Issue Date

08/21/2018

Effective Date

05/10/2024

Expiration Date

09/30/2027

City

NEW LENOX

State

Zip

60451

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2024