CHARLES BRUCE POLK DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012051

License Status

INACTIVE

Business

First Name

CHARLES BRUCE

Last Name

POLK

Suffix

DDS

Business Name

CHARLES BRUCE POLK DDS

Original Issue Date

07/03/1962

Effective Date

07/03/1962

Expiration Date

09/30/1992

City

PHOENIX

State

Zip

85018

County

ARIZONA

Ever Disciplined

LastModifiedDate

10/12/2005