Azaryas Tadiwos Mandefro Dmd
ExpiredIllinois license 31*****19
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 31*****19
- 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 Controlled Substance (Dental) Dental
More from the license record
- Controlled substance schedules
- III IV V
- Current term began
- 04/01/2011
Other Illinois licenses under this name
-
IL
ExpiredSaint Peters, MOExpired Sep 30, 2012
Contact
East Saint Louis, IL 62205
Saint Clair County