ENRIQUE TUESTA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

NOT RENEWED

Business

First Name

ENRIQUE

Last Name

TUESTA

Suffix

DMD

Business Name

ENRIQUE TUESTA DMD

Original Issue Date

06/08/2007

Effective Date

06/08/2007

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