LAWRENCE NORMAN WALLACE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000126

License Status

NOT RENEWED

Business

First Name

LAWRENCE NORMAN

Last Name

WALLACE

Suffix

DDS

Business Name

LAWRENCE NORMAN WALLACE DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

DES PLAINES

State

Zip

60016

County

COOK

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

10/13/2005