FREDERICK KENNED SLACK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011052

License Status

NOT RENEWED

Business

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

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

10/12/2005