FREDERICK KENNED SLACK DDS - Dentist License in Illinois | # 019011052

FREDERICK KENNED SLACK DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011052

License Status

NOT RENEWED

Business

N

First Name

FREDERICK KENNED

Last Name

SLACK

Suffix

DDS

Business Name

FREDERICK KENNED SLACK DDS

Original Issue Date

02/27/1957

Effective Date

02/27/1957

Expiration Date

09/30/1984

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005