RICHARD ANTHONY PENA DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012770

License Status

INACTIVE

Business

First Name

RICHARD

Middle

ANTHONY

Last Name

PENA

Suffix

DDS

Business Name

RICHARD ANTHONY PENA DDS

Original Issue Date

07/15/1965

Effective Date

06/19/2012

Expiration Date

09/30/2015

City

DARIEN

State

Zip

60561

County

DUPAGE

Ever Disciplined

LastModifiedDate

06/08/2015