HARRY W HUMPHREYS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021001819

License Status

NOT RENEWED

Business

First Name

HARRY W

Last Name

HUMPHREYS

Business Name

HARRY W HUMPHREYS

Original Issue Date

11/19/1996

Effective Date

09/24/2009

Expiration Date

09/30/2012

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

11/14/2012