MATTHEW C MANDEVILLE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000587

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

MANDEVILLE

Business Name

MATTHEW C MANDEVILLE

Original Issue Date

08/23/1991

Effective Date

08/23/1991

Expiration Date

06/30/1993

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

LastModifiedDate

07/30/2018