TERRENCE MARTIN WALL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000183

License Status

NOT RENEWED

Business

First Name

TERRENCE

Middle

MARTIN

Last Name

WALL

Suffix

DDS

Business Name

TERRENCE MARTIN WALL DDS

Original Issue Date

12/30/1989

Effective Date

07/12/2012

Expiration Date

09/30/2015

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

02/08/2016