MARTHA P VILLALOBOS - Dentist License in Illinois | # 018000619

MARTHA P VILLALOBOS

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000619

License Status

NOT RENEWED

Business

N

First Name

MARTHA

Middle

P

Last Name

VILLALOBOS

Business Name

MARTHA P VILLALOBOS

Original Issue Date

06/24/1992

Effective Date

06/24/1992

Expiration Date

06/30/1994

State

IL

Specialty/Qualifier

Periodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005