GABRIEL J L VILLENA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

NOT RENEWED

Business

First Name

GABRIEL J L

Last Name

VILLENA

Business Name

GABRIEL J L VILLENA

Original Issue Date

09/12/1990

Effective Date

09/12/1990

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60634

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/13/2005