GABRIEL E VIDA Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

INOPERATIVE

Business

First Name

GABRIEL E

Last Name

VIDA

Business Name

GABRIEL E VIDA

Original Issue Date

10/19/1987

Effective Date

09/24/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60647

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/24/2024