REGINALD LAMAR FULFORD DDS - Dentist License in Illinois | # 019024917

REGINALD LAMAR FULFORD DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024917

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005