RICARDO ULISES MELCHOR PALMA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****33

License Status

NOT RENEWED

Business

First Name

RICARDO

Middle

ULISES

Last Name

MELCHOR PALMA

Business Name

RICARDO ULISES MELCHOR PALMA

Original Issue Date

08/09/2019

Effective Date

10/19/2021

Expiration Date

09/30/2024

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025