MELISSA DAZA MONDERO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

DAZA

Last Name

MONDERO

Business Name

MELISSA DAZA MONDERO

Original Issue Date

07/24/1996

Effective Date

07/24/1996

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60647

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/08/2006