JOHN WILLIAM ETZENBACH - Dentist License in Ae | # 021001203

JOHN WILLIAM ETZENBACH

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021001203

License Status

INACTIVE

Business

N

First Name

JOHN WILLIAM

Last Name

ETZENBACH

Business Name

JOHN WILLIAM ETZENBACH

Original Issue Date

09/21/1984

Effective Date

09/21/1984

Expiration Date

09/30/2006

State

AE

Specialty/Qualifier

Periodontics

Ever Disciplined

N

LastModifiedDate

07/24/2006