ALAN JOSEPH WICKENHAUSER DMD

Business Entity
NOT RENEWED

Dentist

LICENSED DENTIST CONTROLLED SUBSTANCE

31*****93

NOT RENEWED

N

ALAN

JOSEPH

WICKENHAUSER

DMD

ALAN JOSEPH WICKENHAUSER DMD

08/21/1998

08/21/1998

09/30/2000

HARTFORD

IL

62048

MADISON

II III IV V

N

10/17/2005