DAVID EDWARD WATERFALL DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015319

License Status

NOT RENEWED

Business

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

City

GREAT LAKES

State

Zip

60088

County

LAKE

Ever Disciplined

LastModifiedDate

10/12/2005