JALISA NICOLE BRADLEY DDS - Dentist License in Illinois | # 018002011

JALISA NICOLE BRADLEY DDS

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018002011

License Status

EXPIRED

Business

N

Title

DDS

First Name

JALISA

Middle

NICOLE

Last Name

BRADLEY

Business Name

JALISA NICOLE BRADLEY DDS

Original Issue Date

08/11/2016

Effective Date

07/01/2016

Expiration Date

07/01/2017

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

09/19/2017