ROBERT PAUL WIDERQUIST DDS - Dentist License in Wisconsin | # 019014505

ROBERT PAUL WIDERQUIST DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014505

License Status

NOT RENEWED

Business

N

First Name

ROBERT PAUL

Last Name

WIDERQUIST

Suffix

DDS

Business Name

ROBERT PAUL WIDERQUIST DDS

Original Issue Date

12/13/1972

Effective Date

12/13/1972

Expiration Date

09/30/1984

State

WI

Ever Disciplined

N

LastModifiedDate

10/12/2005