TIMOTHY M BLIEDEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019020388

License Status

NOT RENEWED

Business

First Name

TIMOTHY M

Last Name

BLIEDEN

Business Name

TIMOTHY M BLIEDEN

Original Issue Date

10/08/1986

Effective Date

10/08/1986

Expiration Date

09/30/1992

City

LAGRANGE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

10/12/2005