DAVID LAWRENCE WILSON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001124

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

LAWRENCE

Last Name

WILSON

Suffix

DMD

Business Name

DAVID LAWRENCE WILSON DMD

Original Issue Date

08/25/1998

Effective Date

08/25/1998

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005