SAM ADAM CARROLL Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027991

License Status

INACTIVE

Business

First Name

SAM

Middle

ADAM

Last Name

CARROLL

Business Name

SAM ADAM CARROLL

Original Issue Date

06/09/2009

Effective Date

06/09/2009

Expiration Date

09/30/2012

City

GERMANTOWN HILLS

State

Zip

61548

County

WOODFORD

Ever Disciplined

LastModifiedDate

06/06/2012