BRYAN STEPHEN BERTEAUX JR DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

First Name

BRYAN

Middle

STEPHEN

Last Name

BERTEAUX

Suffix

JR DMD

Business Name

BRYAN STEPHEN BERTEAUX JR DMD

Original Issue Date

11/15/1994

Effective Date

11/15/1994

Expiration Date

09/30/2000

City

SMYRNA

State

Zip

30080

County

GEORGIA

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

10/17/2005