LARRY RAY MITTENDORF DDS - Dentist License in Illinois | # 019012602

LARRY RAY MITTENDORF DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012602

License Status

INACTIVE

Business

N

First Name

LARRY RAY

Last Name

MITTENDORF

Suffix

DDS

Business Name

LARRY RAY MITTENDORF DDS

Original Issue Date

07/14/1964

Effective Date

07/14/1964

Expiration Date

09/30/1990

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005