WAYNE JAMES FITZPATRICK DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000181

License Status

CANCELLED

Business

First Name

WAYNE

Middle

JAMES

Last Name

FITZPATRICK

Suffix

DDS

Business Name

WAYNE JAMES FITZPATRICK DDS

Original Issue Date

01/03/1990

Effective Date

01/03/1990

Expiration Date

09/30/2006

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

07/24/2006