CRAIG MANUEL JOS E LA ROSA - Dentist License in Illinois | # 018000751

CRAIG MANUEL JOS E LA ROSA

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000751

License Status

NOT RENEWED

Business

N

First Name

CRAIG MANUEL JOS

Middle

E

Last Name

LA ROSA

Business Name

CRAIG MANUEL JOS E LA ROSA

Original Issue Date

02/03/1994

Effective Date

02/03/1994

Expiration Date

09/14/1999

State

IL

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

N

LastModifiedDate

10/12/2005