JEFFREY HOWARD KOOTMAN Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018917

License Status

INACTIVE

Business

First Name

JEFFREY HOWARD

Last Name

KOOTMAN

Business Name

JEFFREY HOWARD KOOTMAN

Original Issue Date

11/22/1983

Effective Date

11/22/1983

Expiration Date

09/30/1990

City

PHOENIX

State

Zip

85022

County

ARIZONA

Ever Disciplined

LastModifiedDate

10/12/2005