HARLEY BISHOP GRANDIN DDS - Dentist License in Illinois | # 018002110

HARLEY BISHOP GRANDIN DDS

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018002110

License Status

CANCELLED

Business

N

Title

DDS

First Name

HARLEY

Middle

BISHOP

Last Name

GRANDIN

Business Name

HARLEY BISHOP GRANDIN DDS

Original Issue Date

06/28/2019

Effective Date

07/01/2019

Expiration Date

06/30/2021

State

IL

Specialty/Qualifier

Endodontics

Ever Disciplined

N

LastModifiedDate

06/28/2019