DIANA LOPEZ DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

ACTIVE

Business

Title

DMD

First Name

DIANA

Last Name

LOPEZ

Business Name

DIANA LOPEZ DMD

Original Issue Date

06/23/2025

Effective Date

06/23/2025

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61701

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2025