THAIZE LARA MELO DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

ACTIVE

Business

First Name

THAIZE

Middle

LARA

Last Name

MELO

Suffix

DDS

Business Name

THAIZE LARA MELO DDS

Original Issue Date

03/16/2010

Effective Date

09/12/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/12/2024