EDWARD L MODESTO DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021001586

License Status

INACTIVE

Business

First Name

EDWARD L

Last Name

MODESTO

Suffix

DDS

Business Name

EDWARD L MODESTO DDS

Original Issue Date

11/19/1991

Effective Date

08/13/2012

Expiration Date

09/30/2015

City

ORLAND PARK

State

Zip

60467

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

06/08/2015