THOMAS J WALLEN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014175

License Status

INACTIVE

Business

First Name

THOMAS J

Last Name

WALLEN

Suffix

DDS

Business Name

THOMAS J WALLEN DDS

Original Issue Date

07/08/1971

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

CRYSTAL LAKE

State

Zip

60012

County

MCHENRY

Ever Disciplined

LastModifiedDate

06/04/2009