JACQUELINE M RODRIGUEZ Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

ACTIVE

Business

First Name

JACQUELINE

Middle

Last Name

RODRIGUEZ

Business Name

JACQUELINE M RODRIGUEZ

Original Issue Date

05/18/2017

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60614

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/20/2025