DALE KONRAD KOSTIWA - Dentist License in Illinois | # 019011671

DALE KONRAD KOSTIWA

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011671

License Status

INACTIVE

Business

N

First Name

DALE KONRAD

Last Name

KOSTIWA

Business Name

DALE KONRAD KOSTIWA

Original Issue Date

07/27/1960

Effective Date

07/27/1960

Expiration Date

09/30/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005