WAYNE JAMES FITZPATRICK DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012435

License Status

INACTIVE

Business

First Name

WAYNE

Middle

JAMES

Last Name

FITZPATRICK

Suffix

DDS

Business Name

WAYNE JAMES FITZPATRICK DDS

Original Issue Date

05/28/1964

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

07/24/2006