KENNETH J MORAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000213

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

Last Name

MORAN

Business Name

KENNETH J MORAN

Original Issue Date

10/28/1987

Effective Date

10/28/1987

Expiration Date

10/28/1989

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005