MAKOTO SUGIUCHI DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****98

License Status

CANCELLED

Business

First Name

MAKOTO

Last Name

SUGIUCHI

Suffix

DDS

Business Name

MAKOTO SUGIUCHI DDS

Original Issue Date

10/20/2003

Effective Date

10/20/2003

Expiration Date

09/30/2004

City

ROSELLE

State

Zip

60172

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005