DALE CHARLES NICKELSEN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012082

License Status

INACTIVE

Business

First Name

DALE CHARLES

Last Name

NICKELSEN

Suffix

DDS

Business Name

DALE CHARLES NICKELSEN DDS

Original Issue Date

08/02/1962

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

ELGIN

State

Zip

60124

County

KANE

Ever Disciplined

LastModifiedDate

06/06/2012