WAYNE W BEACH DDS - Dentist License in Illinois | # 019012055

WAYNE W BEACH DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012055

License Status

NOT RENEWED

Business

N

First Name

WAYNE

Middle

W

Last Name

BEACH

Suffix

DDS

Business Name

WAYNE W BEACH DDS

Original Issue Date

08/01/1962

Effective Date

08/01/1962

Expiration Date

09/30/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005