WALTER DONALD MADDOX Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011176

License Status

INACTIVE

Business

First Name

WALTER DONALD

Last Name

MADDOX

Business Name

WALTER DONALD MADDOX

Original Issue Date

09/10/1957

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

07/24/2006