JOHN R BOTTALA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000226

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

Last Name

BOTTALA

Business Name

JOHN R BOTTALA

Original Issue Date

05/27/1988

Effective Date

05/27/1988

Expiration Date

06/30/1989

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005