JERRY LEE SODERSTROM DDS - Dentist License in Illinois | # 019018865

JERRY LEE SODERSTROM DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018865

License Status

NOT RENEWED

Business

N

First Name

JERRY

Middle

LEE

Last Name

SODERSTROM

Suffix

DDS

Business Name

JERRY LEE SODERSTROM DDS

Original Issue Date

10/03/1983

Effective Date

10/03/1983

Expiration Date

09/30/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005