RICHARD ANTHONY PENA DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

CANCELLED

Business

First Name

RICHARD

Middle

ANTHONY

Last Name

PENA

Suffix

DDS

Business Name

RICHARD ANTHONY PENA DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2006

City

DARIEN

State

Zip

60561

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2006