REGINALD LAMAR FULFORD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024917

License Status

NOT RENEWED

Business

First Name

REGINALD

Middle

LAMAR

Last Name

FULFORD

Suffix

DDS

Business Name

REGINALD LAMAR FULFORD DDS

Original Issue Date

12/02/1998

Effective Date

12/02/1998

Expiration Date

09/30/2004

City

RIVER FOREST

State

Zip

60305

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005