LEONOR C VILLALTA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019029681

License Status

NOT RENEWED

Business

Title

DDS

First Name

LEONOR

Middle

Last Name

VILLALTA

Business Name

LEONOR C VILLALTA DDS

Original Issue Date

11/20/2013

Effective Date

09/04/2015

Expiration Date

09/30/2018

City

INDIANAPOLIS

State

Zip

46214

County

INDIANA

Ever Disciplined

LastModifiedDate

10/31/2018