MITCHELL S PARKER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000499

License Status

NOT RENEWED

Business

First Name

MITCHELL

Middle

Last Name

PARKER

Business Name

MITCHELL S PARKER

Original Issue Date

08/07/1990

Effective Date

08/07/1990

Expiration Date

06/30/1991

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005