CHARLES H EKSTROM DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014038

License Status

INACTIVE

Business

First Name

CHARLES H

Last Name

EKSTROM

Suffix

DDS

Business Name

CHARLES H EKSTROM DDS

Original Issue Date

07/08/1971

Effective Date

07/08/1971

Expiration Date

09/30/2002

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005