PETER RALPH VANDERSLOOT DDS - Dentist License in Illinois | # 018001519

PETER RALPH VANDERSLOOT DDS

Business Entity

ACTIVE

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001519

License Status

ACTIVE

Business

N

First Name

PETER

Middle

RALPH

Last Name

VANDERSLOOT

Suffix

DDS

Business Name

PETER RALPH VANDERSLOOT DDS

Original Issue Date

09/29/2004

Effective Date

09/29/2004

Expiration Date

01/31/3004

State

IL

Specialty/Qualifier

Endodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005