LORENZO J MODESTE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

NOT RENEWED

Business

First Name

LORENZO J

Last Name

MODESTE

Suffix

DDS

Business Name

LORENZO J MODESTE DDS

Original Issue Date

12/26/1991

Effective Date

12/26/1991

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60643

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005