JAIME BALLESTEROS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

ACTIVE

Business

First Name

JAIME

Last Name

BALLESTEROS

Suffix

DMD

Business Name

JAIME BALLESTEROS DMD

Original Issue Date

05/02/1995

Effective Date

09/19/2024

Expiration Date

09/30/2027

City

WILLOWBROOK

State

Zip

60527

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/19/2024