BRIAN NELSON Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019031603

License Status

INACTIVE

Business

First Name

BRIAN

Last Name

NELSON

Business Name

BRIAN NELSON

Original Issue Date

06/04/2018

Effective Date

09/29/2021

Expiration Date

09/30/2024

City

PHOENIX

State

Zip

85044

Ever Disciplined

LastModifiedDate

09/06/2022