MARIE GABRIELA CHAVARRIA - Dentist License in Illinois | # 136000104

MARIE GABRIELA CHAVARRIA

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000104

License Status

EXPIRED

Business

N

First Name

MARIE

Middle

GABRIELA

Last Name

CHAVARRIA

Business Name

MARIE GABRIELA CHAVARRIA

Original Issue Date

11/24/2004

Effective Date

11/24/2004

Expiration Date

06/30/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/13/2005