LOURDES ELENTO BALQUIEDRA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****86

License Status

NOT RENEWED

Business

First Name

LOURDES ELENTO

Last Name

BALQUIEDRA

Suffix

DMD

Business Name

LOURDES ELENTO BALQUIEDRA DMD

Original Issue Date

08/08/2008

Effective Date

08/08/2008

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009