LOURDES ELENTO BALQUIEDRA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****19

License Status

NOT RENEWED

Business

First Name

LOURDES ELENTO

Last Name

BALQUIEDRA

Suffix

DMD

Business Name

LOURDES ELENTO BALQUIEDRA DMD

Original Issue Date

01/01/1998

Effective Date

08/13/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60632

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016