GLENN FREDERICK EDMISTON III DDS - Dentist License in Illinois | # 021000893

GLENN FREDERICK EDMISTON III DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000893

License Status

NOT RENEWED

Business

N

First Name

GLENN FREDERICK

Last Name

EDMISTON III

Suffix

DDS

Business Name

GLENN FREDERICK EDMISTON III DDS

Original Issue Date

12/09/1976

Effective Date

08/03/2012

Expiration Date

09/30/2015

State

IL

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

N

LastModifiedDate

02/08/2016