MARTIN RUSSELL SULLIVAN DDS - Dentist License in Illinois | # 019009282

MARTIN RUSSELL SULLIVAN DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019009282

License Status

NOT RENEWED

Business

N

First Name

MARTIN RUSSELL

Last Name

SULLIVAN

Suffix

DDS

Business Name

MARTIN RUSSELL SULLIVAN DDS

Original Issue Date

08/04/1947

Effective Date

08/04/1947

Expiration Date

09/30/1994

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005