SUSAN J ELLENZ DDS - Dentist License in Illinois | # 021001433

SUSAN J ELLENZ DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021001433

License Status

INACTIVE

Business

N

First Name

SUSAN J

Last Name

ELLENZ

Suffix

DDS

Business Name

SUSAN J ELLENZ DDS

Original Issue Date

08/01/1989

Effective Date

10/01/2012

Expiration Date

09/30/2015

State

IL

Specialty/Qualifier

Endodontics

Ever Disciplined

N

LastModifiedDate

06/08/2015