Individual
LAURA JEANNE DONLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7314 N. WILLOW LAKE CT., SUITE D, PEORIA, IL 61614-8289
(309) 692-0175
(309) 692-3139
Mailing address
7314 N. WILLOW LAKE CT., SUITE D, PEORIA, IL 61614-8289
(309) 692-0175
(309) 692-3139
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D19-023606
IL
Other
Enumeration date
11/25/2009
Last updated
11/25/2009
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