WAYNE VAN SAUN GILLIAM Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010463

License Status

INACTIVE

Business

First Name

WAYNE VAN SAUN

Last Name

GILLIAM

Business Name

WAYNE VAN SAUN GILLIAM

Original Issue Date

08/04/1954

Effective Date

08/04/1954

Expiration Date

09/30/1990

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/12/2005