BERTHA M DIEGUEZ-MARINO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000414

License Status

NOT RENEWED

Business

First Name

BERTHA

Middle

Last Name

DIEGUEZ-MARINO

Business Name

BERTHA M DIEGUEZ-MARINO

Original Issue Date

05/18/1990

Effective Date

05/18/1990

Expiration Date

06/10/1992

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005