MARIDITH G DE JESUS 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

MARIDITH G

Last Name

DE JESUS

Business Name

MARIDITH G DE JESUS

Original Issue Date

12/03/1996

Effective Date

09/08/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018