GERUSA S MELLO-BURSTADT DDS - Dentist License in Illinois | # 021001860

GERUSA S MELLO-BURSTADT DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021001860

License Status

NOT RENEWED

Business

N

First Name

GERUSA S

Last Name

MELLO-BURSTADT

Suffix

DDS

Business Name

GERUSA S MELLO-BURSTADT DDS

Original Issue Date

09/18/1997

Effective Date

06/13/2018

Expiration Date

01/31/2022

State

IL

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

N

LastModifiedDate

05/09/2022