MATTHEW RALPH BAUMGARTH - Dentist License in Illinois | # 018001091

MATTHEW RALPH BAUMGARTH

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001091

License Status

NOT RENEWED

Business

N

First Name

MATTHEW RALPH

Last Name

BAUMGARTH

Business Name

MATTHEW RALPH BAUMGARTH

Original Issue Date

01/06/1998

Effective Date

01/06/1998

Expiration Date

06/30/1999

State

IL

Specialty/Qualifier

Endodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005