PAUL MICHAEL BROADWATER - Dentist License in Utah | # 019019136

PAUL MICHAEL BROADWATER

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019019136

License Status

NOT RENEWED

Business

N

First Name

PAUL MICHAEL

Last Name

BROADWATER

Business Name

PAUL MICHAEL BROADWATER

Original Issue Date

08/02/1984

Effective Date

08/02/1984

Expiration Date

09/30/1988

State

UT

Ever Disciplined

N

LastModifiedDate

10/12/2005