ALEXANDER PETROVICH RUDNITSKI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001974

License Status

NOT RENEWED

Business

Title

DMD

First Name

ALEXANDER

Middle

PETROVICH

Last Name

RUDNITSKI

Business Name

ALEXANDER PETROVICH RUDNITSKI DMD

Original Issue Date

09/11/2015

Effective Date

07/01/2015

Expiration Date

06/30/2016

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

03/09/2017