JORGE ENRIQUE MOSQUERA CASTRILLON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137001129

License Status

ACTIVE

Business

First Name

JORGE

Middle

ENRIQUE

Last Name

MOSQUERA CASTRILLON

Business Name

JORGE ENRIQUE MOSQUERA CASTRILLON

Original Issue Date

12/18/2023

Effective Date

05/05/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

05/05/2024