EMMANUELA MENA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

First Name

EMMANUELA

Last Name

MENA

Suffix

DDS

Business Name

EMMANUELA MENA DDS

Original Issue Date

01/23/2008

Effective Date

01/23/2008

Expiration Date

09/30/2009

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009