DENNIS WAYNE FREDRICKSON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027244

License Status

ACTIVE

Business

First Name

DENNIS

Middle

WAYNE

Last Name

FREDRICKSON

Suffix

DMD

Business Name

DENNIS WAYNE FREDRICKSON DMD

Original Issue Date

11/13/2006

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

05/02/2024