JUSTIN P SALEM DDS - Dentist License in Illinois | # 018000772

JUSTIN P SALEM DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000772

License Status

NOT RENEWED

Business

N

First Name

JUSTIN P

Last Name

SALEM

Suffix

DDS

Business Name

JUSTIN P SALEM DDS

Original Issue Date

06/24/1994

Effective Date

06/24/1994

Expiration Date

06/30/1995

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005