ANDREW ADIPUTRA - Dentist License in Illinois | # 019032270

ANDREW ADIPUTRA

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019032270

License Status

ACTIVE

Business

N

First Name

ANDREW

Last Name

ADIPUTRA

Business Name

ANDREW ADIPUTRA

Original Issue Date

07/23/2019

Effective Date

09/27/2024

Expiration Date

09/30/2027

State

IL

Ever Disciplined

N

LastModifiedDate

09/27/2024