HAROLD ANTHONY BLACK DDS - Dentist License in Wisconsin | # 019014522

HAROLD ANTHONY BLACK DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014522

License Status

INACTIVE

Business

N

First Name

HAROLD ANTHONY

Last Name

BLACK

Suffix

DDS

Business Name

HAROLD ANTHONY BLACK DDS

Original Issue Date

07/11/1973

Effective Date

07/11/1973

Expiration Date

09/30/2004

State

WI

Ever Disciplined

N

LastModifiedDate

10/17/2005