Larry Wallace Mizelle

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

019020062

Status

Expired (Not Renewed)

First issued

June 4, 1986

Expired

September 30, 2004

License holder

Larry Wallace Mizelle

Entity type

Individual

Classifications

• Licensed Dentist (Dental) Dental

More from the license record

Current term began

06/04/1986

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