DANIEL WOLTER DMD - Dentist License in Illinois | # 018001001

DANIEL WOLTER DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001001

License Status

NOT RENEWED

Business

N

First Name

DANIEL

Last Name

WOLTER

Suffix

DMD

Business Name

DANIEL WOLTER DMD

Original Issue Date

12/03/1996

Effective Date

12/03/1996

Expiration Date

09/30/1997

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005