MARTIN ALFONSO RUELAS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

ACTIVE

Business

First Name

MARTIN ALFONSO

Last Name

RUELAS

Suffix

DMD

Business Name

MARTIN ALFONSO RUELAS DMD

Original Issue Date

11/21/1997

Effective Date

05/09/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2024