CHANTISTE BEAL DMD - Dentist License in Illinois | # 018001589

CHANTISTE BEAL DMD

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001589

License Status

CANCELLED

Business

N

Title

DMD

First Name

CHANTISTE

Last Name

BEAL

Business Name

CHANTISTE BEAL DMD

Original Issue Date

06/22/2006

Effective Date

06/22/2006

Expiration Date

06/30/2010

State

IL

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

N

LastModifiedDate

06/22/2006