AUSTIN JEFFREY DEPORTER DMD - Dentist License in Illinois | # 019029653

AUSTIN JEFFREY DEPORTER DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019029653

License Status

NOT RENEWED

Business

N

Title

DMD

First Name

AUSTIN

Middle

JEFFREY

Last Name

DEPORTER

Business Name

AUSTIN JEFFREY DEPORTER DMD

Original Issue Date

09/25/2013

Effective Date

08/20/2015

Expiration Date

09/30/2018

State

IL

Ever Disciplined

N

LastModifiedDate

10/31/2018