Azaryas Tadiwos Mandefro Dmd

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

019028572

Status

Expired (Not Renewed)

First issued

April 1, 2011

Expired

September 30, 2012

License holder

Azaryas Tadiwos Mandefro Dmd

Entity type

Individual

Classifications

• Licensed Dentist (Dental) Dental

More from the license record

Current term began

04/01/2011

Other Illinois licenses under this name

• IL
  Azaryas Tadiwos Mandefro Dmd

  License 31*****19

  Licensed Dentist Controlled Substance (Dental)
  Expired

  East Saint Louis, IL

  Expired Sep 30, 2012

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