KEVIN R WALLACE DMD - Dentist License in Illinois | # 019022339

KEVIN R WALLACE DMD

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019022339

License Status

ACTIVE

Business

N

First Name

KEVIN R

Last Name

WALLACE

Suffix

DMD

Business Name

KEVIN R WALLACE DMD

Original Issue Date

12/08/1990

Effective Date

07/17/2024

Expiration Date

09/30/2027

State

IL

Ever Disciplined

N

LastModifiedDate

07/17/2024