GRACE NANTALE DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001805

License Status

EXPIRED

Business

Title

DDS

First Name

GRACE

Last Name

NANTALE

Business Name

GRACE NANTALE DDS

Original Issue Date

06/16/2011

Effective Date

06/24/2011

Expiration Date

06/30/2012

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

08/29/2012