ALEXANDRA C FULREADER DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001871

License Status

CANCELLED

Business

Title

DDS

First Name

ALEXANDRA

Middle

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

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

03/13/2015