CHARLES JEROME WILTZ DDS - Dentist License in Illinois | # 019013542

CHARLES JEROME WILTZ DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013542

License Status

INACTIVE

Business

N

Title

DDS

First Name

CHARLES

Middle

JEROME

Last Name

WILTZ

Business Name

CHARLES JEROME WILTZ DDS

Original Issue Date

12/19/1968

Effective Date

06/16/2009

Expiration Date

09/30/2012

State

IL

Ever Disciplined

N

LastModifiedDate

06/06/2012