JEROLD COLLINS WILDE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001051

License Status

NOT RENEWED

Business

First Name

JEROLD COLLINS

Last Name

WILDE

Suffix

DDS

Business Name

JEROLD COLLINS WILDE DDS

Original Issue Date

07/17/1997

Effective Date

07/17/1997

Expiration Date

06/30/1998

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005