LARRY DEAN WILBORN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012822

License Status

NOT RENEWED

Business

First Name

LARRY DEAN

Last Name

WILBORN

Suffix

DDS

Business Name

LARRY DEAN WILBORN DDS

Original Issue Date

07/15/1965

Effective Date

07/15/1965

Expiration Date

09/30/1990

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/12/2005