MASARU ISHIGAME DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001257

License Status

NOT RENEWED

Business

First Name

MASARU

Last Name

ISHIGAME

Suffix

DDS

Business Name

MASARU ISHIGAME DDS

Original Issue Date

12/05/2000

Effective Date

12/05/2000

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005