JOHN R BOTTALA - Dentist License in Illinois | # 018000226

JOHN R BOTTALA

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000226

License Status

NOT RENEWED

Business

N

First Name

JOHN

Middle

R

Last Name

BOTTALA

Business Name

JOHN R BOTTALA

Original Issue Date

05/27/1988

Effective Date

05/27/1988

Expiration Date

06/30/1989

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005