PETER RALPH VANDERSLOOT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025878

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005