LESLIE DAVID BURBIDGE JR DDS - Dentist License in Utah | # 019012463

LESLIE DAVID BURBIDGE JR DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012463

License Status

NOT RENEWED

Business

N

First Name

LESLIE DAVID

Last Name

BURBIDGE JR

Suffix

DDS

Business Name

LESLIE DAVID BURBIDGE JR DDS

Original Issue Date

07/14/1964

Effective Date

07/14/1964

Expiration Date

09/30/1986

State

UT

Ever Disciplined

N

LastModifiedDate

10/12/2005