JOHN T LISAC DDS - Dentist License in Illinois | # 018000460

JOHN T LISAC DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000460

License Status

NOT RENEWED

Business

N

First Name

JOHN T

Last Name

LISAC

Suffix

DDS

Business Name

JOHN T LISAC DDS

Original Issue Date

06/29/1990

Effective Date

06/29/1990

Expiration Date

06/10/1992

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005