KELLY AIDAN BLUNDELL DMD - Dentist License in Illinois | # 018001345

KELLY AIDAN BLUNDELL DMD

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001345

License Status

EXPIRED

Business

N

First Name

KELLY

Middle

AIDAN

Last Name

BLUNDELL

Suffix

DMD

Business Name

KELLY AIDAN BLUNDELL DMD

Original Issue Date

06/19/2002

Effective Date

06/19/2002

Expiration Date

06/30/2004

State

IL

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

N

LastModifiedDate

07/30/2018