NEIL M WALLE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000339

License Status

NOT RENEWED

Business

First Name

NEIL M

Last Name

WALLE

Business Name

NEIL M WALLE

Original Issue Date

06/06/1989

Effective Date

06/06/1989

Expiration Date

06/30/1991

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005