Jack William Balenseifen

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

019013088

Status

Inactive

First issued

July 20, 1967

Expired

September 30, 1990

License holder

Jack William Balenseifen

Entity type

Individual

Classifications

• Licensed Dentist (Dental) Dental

More from the license record

Current term began

07/20/1967

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