FREDERICK AGUILA R MENDOZA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000993

License Status

NOT RENEWED

Business

First Name

FREDERICK AGUILA

Middle

Last Name

MENDOZA

Business Name

FREDERICK AGUILA R MENDOZA

Original Issue Date

10/01/1996

Effective Date

10/01/1996

Expiration Date

06/30/1997

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/12/2005