MICHAEL LOUIS SANTUCCI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

NOT RENEWED

Business

First Name

MICHAEL LOUIS

Last Name

SANTUCCI

Suffix

DDS

Business Name

MICHAEL LOUIS SANTUCCI DDS

Original Issue Date

01/01/1998

Effective Date

06/12/2018

Expiration Date

01/31/2022

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022