ALEXANDRA C FULREADER DDS - Dentist License in Illinois | # 018001871

ALEXANDRA C FULREADER DDS

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001871

License Status

CANCELLED

Business

N

Title

DDS

First Name

ALEXANDRA

Middle

C

Last Name

FULREADER

Business Name

ALEXANDRA C FULREADER DDS

Original Issue Date

06/03/2013

Effective Date

06/24/2013

Expiration Date

06/30/2014

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

03/13/2015