SUSAN TERESA STAKIW - Dentist License in Illinois | # 136000078

SUSAN TERESA STAKIW

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000078

License Status

EXPIRED

Business

N

First Name

SUSAN

Middle

TERESA

Last Name

STAKIW

Business Name

SUSAN TERESA STAKIW

Original Issue Date

08/07/2001

Effective Date

08/07/2001

Expiration Date

08/19/2006

State

IL

Ever Disciplined

N

LastModifiedDate

11/03/2006