OTTO F TIDWELL DDS - Dentist License in Pennsylvania | # 019019526

OTTO F TIDWELL DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019019526

License Status

NOT RENEWED

Business

N

First Name

OTTO

Middle

F

Last Name

TIDWELL

Suffix

DDS

Business Name

OTTO F TIDWELL DDS

Original Issue Date

05/14/1985

Effective Date

05/14/1985

Expiration Date

09/30/1988

State

PA

Ever Disciplined

N

LastModifiedDate

10/12/2005