BERTRAM FIVELSON DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010791

License Status

INACTIVE

Business

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

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Ever Disciplined

LastModifiedDate

10/12/2005