MARTIN S WALLER Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012019

License Status

ACTIVE

Business

First Name

MARTIN

Middle

Last Name

WALLER

Business Name

MARTIN S WALLER

Original Issue Date

06/04/2007

Effective Date

09/27/2024

Expiration Date

09/30/2027

City

POSEN

State

Zip

60469

County

COOK

Ever Disciplined

LastModifiedDate

09/27/2024