EDGAR IVAN AVILA LOPEZ Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020016772

License Status

ACTIVE

Business

First Name

EDGAR

Middle

IVAN

Last Name

AVILA LOPEZ

Business Name

EDGAR IVAN AVILA LOPEZ

Original Issue Date

10/18/2019

Effective Date

09/25/2024

Expiration Date

09/30/2027

City

KENOSHA

State

Zip

53140

Ever Disciplined

LastModifiedDate

09/25/2024