MAYA A BENES Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

NOT RENEWED

Business

First Name

MAYA

Middle

Last Name

BENES

Business Name

MAYA A BENES

Original Issue Date

06/27/2016

Effective Date

09/27/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025