JACK WILLIAM BALENSEIFEN - Dentist License in Oklahoma | # 019013088

JACK WILLIAM BALENSEIFEN

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013088

License Status

INACTIVE

Business

N

First Name

JACK WILLIAM

Last Name

BALENSEIFEN

Business Name

JACK WILLIAM BALENSEIFEN

Original Issue Date

07/20/1967

Effective Date

07/20/1967

Expiration Date

09/30/1990

State

OK

Ever Disciplined

N

LastModifiedDate

10/12/2005