DAVID EDWARD WATERFALL DMD - Dentist License in Illinois | # 019015319

DAVID EDWARD WATERFALL DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015319

License Status

NOT RENEWED

Business

N

First Name

DAVID EDWARD

Last Name

WATERFALL

Suffix

DMD

Business Name

DAVID EDWARD WATERFALL DMD

Original Issue Date

09/09/1975

Effective Date

09/09/1975

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005