GORDON BALLANTIN CROUCH DMD - Dentist License in Connecticut | # 019013334

GORDON BALLANTIN CROUCH DMD

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013334

License Status

INACTIVE

Business

N

First Name

GORDON BALLANTIN

Last Name

CROUCH

Suffix

DMD

Business Name

GORDON BALLANTIN CROUCH DMD

Original Issue Date

07/16/1968

Effective Date

07/16/1968

Expiration Date

09/30/1992

State

CT

Ever Disciplined

N

LastModifiedDate

10/12/2005