RAYMOND SAMSON BALONGAG DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015045

License Status

NOT RENEWED

Business

First Name

RAYMOND SAMSON

Last Name

BALONGAG

Suffix

DMD

Business Name

RAYMOND SAMSON BALONGAG DMD

Original Issue Date

01/14/1975

Effective Date

01/14/1975

Expiration Date

09/30/2002

City

ELGIN

State

Zip

60123

County

KANE

Ever Disciplined

LastModifiedDate

10/17/2005