RICHARD ANTHONY PENA DDS - Dentist License in Illinois | # 019012770

RICHARD ANTHONY PENA DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012770

License Status

INACTIVE

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

06/08/2015