MICHELLE T VILLANUEVA 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

MICHELLE

Middle

Last Name

VILLANUEVA

Suffix

DDS

Business Name

MICHELLE T VILLANUEVA DDS

Original Issue Date

09/04/2003

Effective Date

09/04/2003

Expiration Date

09/30/2006

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/25/2007