PETER RALPH VANDERSLOOT DDS - Dentist License in Illinois | # 019025878

PETER RALPH VANDERSLOOT DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025878

License Status

NOT RENEWED

Business

N

First Name

PETER

Middle

RALPH

Last Name

VANDERSLOOT

Suffix

DDS

Business Name

PETER RALPH VANDERSLOOT DDS

Original Issue Date

06/13/2002

Effective Date

06/13/2002

Expiration Date

09/30/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005