ROBERT DUANE DOUGLAS DMD - Dentist License in Illinois | # 136000055

ROBERT DUANE DOUGLAS DMD

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000055

License Status

EXPIRED

Business

N

First Name

ROBERT

Middle

DUANE

Last Name

DOUGLAS

Suffix

DMD

Business Name

ROBERT DUANE DOUGLAS DMD

Original Issue Date

10/14/1998

Effective Date

10/14/1998

Expiration Date

01/14/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/13/2005