GREGORY K SPACKMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019021767

License Status

NOT RENEWED

Business

First Name

GREGORY K

Last Name

SPACKMAN

Business Name

GREGORY K SPACKMAN

Original Issue Date

09/30/1989

Effective Date

09/30/1989

Expiration Date

09/30/1994

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

10/12/2005