LAWRENCE JOSEPH GINESTRA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****98

License Status

NOT RENEWED

Business

First Name

LAWRENCE JOSEPH

Last Name

GINESTRA

Business Name

LAWRENCE JOSEPH GINESTRA

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005