GLENN JAMES RESIDE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002020

License Status

NOT RENEWED

Business

First Name

GLENN

Middle

JAMES

Last Name

RESIDE

Business Name

GLENN JAMES RESIDE

Original Issue Date

03/11/2002

Effective Date

03/11/2002

Expiration Date

09/30/2004

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/17/2005