STACEY L DELBRIDGE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000253

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

Last Name

DELBRIDGE

Business Name

STACEY L DELBRIDGE

Original Issue Date

06/25/1988

Effective Date

06/25/1988

Expiration Date

06/24/1990

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

10/12/2005