JUAN G MESA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

JUAN

Middle

Last Name

MESA

Suffix

DDS

Business Name

JUAN G MESA DDS

Original Issue Date

10/30/2002

Effective Date

09/18/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60618

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/09/2022