CARLOS J ROA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

ACTIVE

Business

First Name

CARLOS J

Last Name

ROA

Business Name

CARLOS J ROA

Original Issue Date

10/21/1991

Effective Date

08/09/2024

Expiration Date

09/30/2027

City

DUNLAP

State

Zip

61525

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/09/2024