TAR C AW DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000433

License Status

NOT RENEWED

Business

First Name

TAR

Middle

Last Name

Suffix

DDS

Business Name

TAR C AW DDS

Original Issue Date

06/04/1990

Effective Date

06/04/1990

Expiration Date

06/30/1991

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

10/12/2005