ELWOOD HENRY STADE DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012859

License Status

INACTIVE

Business

First Name

ELWOOD HENRY

Last Name

STADE

Suffix

DDS

Business Name

ELWOOD HENRY STADE DDS

Original Issue Date

11/23/1965

Effective Date

11/23/1965

Expiration Date

09/30/1990

City

EAST ALTON

State

Zip

62024

County

MADISON

Ever Disciplined

LastModifiedDate

10/12/2005