BARRY MICHAEL ENTIN DDS - Dentist License in Illinois | # 021001048

BARRY MICHAEL ENTIN DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021001048

License Status

NOT RENEWED

Business

N

First Name

BARRY MICHAEL

Last Name

ENTIN

Suffix

DDS

Business Name

BARRY MICHAEL ENTIN DDS

Original Issue Date

06/12/1980

Effective Date

06/12/1980

Expiration Date

09/30/2002

State

IL

Specialty/Qualifier

Periodontics

Ever Disciplined

N

LastModifiedDate

10/17/2005