ROGER WALLACE DETTRO DDS - Dentist License in Illinois | # 019011883

ROGER WALLACE DETTRO DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011883

License Status

NOT RENEWED

Business

N

First Name

ROGER WALLACE

Last Name

DETTRO

Suffix

DDS

Business Name

ROGER WALLACE DETTRO DDS

Original Issue Date

07/31/1961

Effective Date

07/31/1961

Expiration Date

09/30/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005