DERRICK O FRYE - Dentist License in Illinois | # 018000497

DERRICK O FRYE

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000497

License Status

NOT RENEWED

Business

N

First Name

DERRICK O

Last Name

FRYE

Business Name

DERRICK O FRYE

Original Issue Date

08/07/1990

Effective Date

08/07/1990

Expiration Date

06/30/1991

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005