RAFAEL DINO C DIMAYUGA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

NOT RENEWED

Business

First Name

RAFAEL

Middle

DINO C

Last Name

DIMAYUGA

Suffix

DDS

Business Name

RAFAEL DINO C DIMAYUGA DDS

Original Issue Date

01/12/2001

Effective Date

01/12/2001

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006