MELANIA LUCIA DACE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****30

License Status

NOT RENEWED

Business

Title

DDS

First Name

MELANIA

Middle

LUCIA

Last Name

DACE

Business Name

MELANIA LUCIA DACE DDS

Original Issue Date

06/23/2011

Effective Date

06/23/2011

Expiration Date

09/30/2012

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012