RALPH DAVID BERENSON - Dentist License in Illinois | # 019010696

RALPH DAVID BERENSON

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010696

License Status

INACTIVE

Business

N

First Name

RALPH DAVID

Last Name

BERENSON

Business Name

RALPH DAVID BERENSON

Original Issue Date

08/10/1955

Effective Date

08/10/1955

Expiration Date

09/30/1990

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005