ERICA SUE WALDAU DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026780

License Status

NOT RENEWED

Business

First Name

ERICA

Middle

SUE

Last Name

WALDAU

Suffix

DMD

Business Name

ERICA SUE WALDAU DMD

Original Issue Date

06/14/2005

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

11/08/2006