WALTER DONALD MADDOX Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000378

License Status

INACTIVE

Business

First Name

WALTER DONALD

Last Name

MADDOX

Business Name

WALTER DONALD MADDOX

Original Issue Date

11/21/1962

Effective Date

11/21/1962

Expiration Date

09/30/1998

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/13/2005