WAYNE JAMES FITZPATRICK DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000656

License Status

INACTIVE

Business

First Name

WAYNE

Middle

JAMES

Last Name

FITZPATRICK

Suffix

DDS

Business Name

WAYNE JAMES FITZPATRICK DDS

Original Issue Date

12/07/1970

Effective Date

12/07/1970

Expiration Date

09/30/2006

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

07/24/2006