ENRICO L MEDINA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****66

License Status

NOT RENEWED

Business

First Name

ENRICO

Middle

Last Name

MEDINA

Suffix

DDS

Business Name

ENRICO L MEDINA DDS

Original Issue Date

07/20/1989

Effective Date

10/15/2018

Expiration Date

01/31/2022

City

NAPERVILLE

State

Zip

60564

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022