LUCIO R MENDONCA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

First Name

LUCIO R

Last Name

MENDONCA

Business Name

LUCIO R MENDONCA

Original Issue Date

08/31/1989

Effective Date

08/31/1989

Expiration Date

09/30/1992

City

CICERO

State

Zip

60650

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005