GRANT KIMBALL STUCKI Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001735

License Status

EXPIRED

Business

First Name

GRANT

Middle

KIMBALL

Last Name

STUCKI

Business Name

GRANT KIMBALL STUCKI

Original Issue Date

06/16/2009

Effective Date

07/01/2009

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/07/2013