MICHAEL ROBERT CUSACK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027507

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ROBERT

Last Name

CUSACK

Business Name

MICHAEL ROBERT CUSACK

Original Issue Date

08/27/2007

Effective Date

01/06/2022

Expiration Date

09/30/2024

City

DURANGO

State

Zip

81301

County

COLORADO

Ever Disciplined

LastModifiedDate

02/04/2025