SIDNEY DAVID GAULT DDS - Dentist License in Illinois | # 019012015

SIDNEY DAVID GAULT DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012015

License Status

NOT RENEWED

Business

N

First Name

SIDNEY DAVID

Last Name

GAULT

Suffix

DDS

Business Name

SIDNEY DAVID GAULT DDS

Original Issue Date

12/11/1961

Effective Date

12/11/1961

Expiration Date

09/30/1996

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005