KRISTI R DETWILER DDS - Dentist License in Illinois | # 018001492

KRISTI R DETWILER DDS

Business Entity

ACTIVE

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001492

License Status

ACTIVE

Business

N

First Name

KRISTI

Middle

R

Last Name

DETWILER

Suffix

DDS

Business Name

KRISTI R DETWILER DDS

Original Issue Date

09/29/2004

Effective Date

09/29/2004

Expiration Date

01/31/3004

State

IL

Specialty/Qualifier

Endodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005