WAYNE STANLEY GRISSOM - Dentist License in Illinois | # 019007979

WAYNE STANLEY GRISSOM

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019007979

License Status

INACTIVE

Business

N

First Name

WAYNE STANLEY

Last Name

GRISSOM

Business Name

WAYNE STANLEY GRISSOM

Original Issue Date

07/30/1940

Effective Date

07/30/1940

Expiration Date

09/30/1992

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005