YVONNE MARIE BALTHAZAR DDS - Dentist License in Wisconsin | # 31*****11

YVONNE MARIE BALTHAZAR DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

NOT RENEWED

Business

N

First Name

YVONNE MARIE

Last Name

BALTHAZAR

Suffix

DDS

Business Name

YVONNE MARIE BALTHAZAR DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1988

State

WI

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

10/13/2005