MARK MATTHEW WIDLOSKI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018084

License Status

NOT RENEWED

Business

First Name

MARK MATTHEW

Last Name

WIDLOSKI

Business Name

MARK MATTHEW WIDLOSKI

Original Issue Date

07/16/1982

Effective Date

07/16/1982

Expiration Date

09/30/1984

City

BROOKFIELD

State

Zip

53005

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005