GERALD LEE LARSON DDS - Dentist License in Wisconsin | # 019011731

GERALD LEE LARSON DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011731

License Status

NOT RENEWED

Business

N

First Name

GERALD LEE

Last Name

LARSON

Suffix

DDS

Business Name

GERALD LEE LARSON DDS

Original Issue Date

08/01/1960

Effective Date

08/01/1960

State

WI

Ever Disciplined

N

LastModifiedDate

10/12/2005