MARIO G RESENDIZ DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

Title

DDS

First Name

MARIO

Middle

Last Name

RESENDIZ

Business Name

MARIO G RESENDIZ DDS

Original Issue Date

01/31/1997

Effective Date

01/31/1997

Expiration Date

09/30/2004

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/17/2005