RENATA REGALADO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

First Name

RENATA

Last Name

REGALADO

Suffix

DMD

Business Name

RENATA REGALADO DMD

Original Issue Date

08/25/1999

Effective Date

08/25/1999

Expiration Date

09/30/2000

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005