TRISCHA RENE TUESTA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

TRISCHA

Middle

RENE

Last Name

TUESTA

Suffix

DMD

Business Name

TRISCHA RENE TUESTA DMD

Original Issue Date

01/11/2008

Effective Date

01/11/2008

Expiration Date

09/30/2009

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009