CANDACE THERESE WAKEFIELD DMD Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000088

License Status

EXPIRED

Business

First Name

CANDACE

Middle

THERESE

Last Name

WAKEFIELD

Suffix

DMD

Business Name

CANDACE THERESE WAKEFIELD DMD

Original Issue Date

01/16/2003

Effective Date

01/16/2003

Expiration Date

01/01/2005

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

10/13/2005