BENJAMIN MARTIN DICKSON DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001405

License Status

EXPIRED

Business

First Name

BENJAMIN

Middle

MARTIN

Last Name

DICKSON

Suffix

DDS

Business Name

BENJAMIN MARTIN DICKSON DDS

Original Issue Date

06/13/2003

Effective Date

06/13/2003

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/12/2005