KENNETH J MORAN - Dentist License in Illinois | # 018000213

KENNETH J MORAN

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000213

License Status

NOT RENEWED

Business

N

First Name

KENNETH

Middle

J

Last Name

MORAN

Business Name

KENNETH J MORAN

Original Issue Date

10/28/1987

Effective Date

10/28/1987

Expiration Date

10/28/1989

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005