HAROLD GORDON HILLAM DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012489

License Status

INACTIVE

Business

First Name

HAROLD GORDON

Last Name

HILLAM

Suffix

DDS

Business Name

HAROLD GORDON HILLAM DDS

Original Issue Date

07/14/1964

Effective Date

07/14/1964

Expiration Date

09/30/1990

City

IDAHO FALLS

State

Zip

83401

County

IDAHO

Ever Disciplined

LastModifiedDate

10/12/2005