PATRICIA A NICKELSON - Dentist License in Illinois | # 018000265

PATRICIA A NICKELSON

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000265

License Status

NOT RENEWED

Business

N

First Name

PATRICIA

Middle

A

Last Name

NICKELSON

Business Name

PATRICIA A NICKELSON

Original Issue Date

07/01/1988

Effective Date

07/01/1988

Expiration Date

06/30/1992

State

IL

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

N

LastModifiedDate

10/12/2005