AUSTIN PENA DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

ACTIVE

Business

Title

DMD

First Name

AUSTIN

Last Name

PENA

Business Name

AUSTIN PENA DMD

Original Issue Date

08/01/2024

Effective Date

08/01/2024

Expiration Date

09/30/2027

City

DANVILLE

State

Zip

61832

County

VERMILION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/01/2024