BRIAN ROBERT CRAWFORD - Dentist License in Idaho | # 31*****25

BRIAN ROBERT CRAWFORD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

NOT RENEWED

Business

N

First Name

BRIAN ROBERT

Last Name

CRAWFORD

Business Name

BRIAN ROBERT CRAWFORD

Original Issue Date

12/06/1989

Effective Date

09/20/2018

Expiration Date

01/31/2022

State

ID

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

05/09/2022