JORGE ENRIQUE MOSQUERA CASTRILLON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

ACTIVE

Business

First Name

JORGE

Middle

ENRIQUE

Last Name

MOSQUERA CASTRILLON

Business Name

JORGE ENRIQUE MOSQUERA CASTRILLON

Original Issue Date

10/02/2020

Effective Date

05/05/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/05/2024