JASON MANTLE KOCH DMD - Dentist License in Kentucky | # 019025214

JASON MANTLE KOCH DMD

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025214

License Status

INACTIVE

Business

N

First Name

JASON

Middle

MANTLE

Last Name

KOCH

Suffix

DMD

Business Name

JASON MANTLE KOCH DMD

Original Issue Date

02/22/2000

Effective Date

02/22/2000

Expiration Date

09/30/2002

State

KY

Ever Disciplined

N

LastModifiedDate

10/17/2005