BERTRAM FIVELSON DDS - Dentist License in Illinois | # 019010791

BERTRAM FIVELSON DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010791

License Status

INACTIVE

Business

N

First Name

BERTRAM

Last Name

FIVELSON

Suffix

DDS

Business Name

BERTRAM FIVELSON DDS

Original Issue Date

09/02/1955

Effective Date

09/02/1955

Expiration Date

09/30/1990

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005