DAVIN EDWARD MELLUS DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000747

License Status

CANCELLED

Business

Title

DMD

First Name

DAVIN

Middle

EDWARD

Last Name

MELLUS

Business Name

DAVIN EDWARD MELLUS DMD

Original Issue Date

01/23/2009

Effective Date

01/23/2009

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

11/15/2011