RAYMOND SAMSON BALONGAG DMD - Dentist License in Illinois | # 019015045

RAYMOND SAMSON BALONGAG DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015045

License Status

NOT RENEWED

Business

N

First Name

RAYMOND SAMSON

Last Name

BALONGAG

Suffix

DMD

Business Name

RAYMOND SAMSON BALONGAG DMD

Original Issue Date

01/14/1975

Effective Date

01/14/1975

Expiration Date

09/30/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005