FREDERICK CHARLE BURNHAM Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018491

License Status

INACTIVE

Business

First Name

FREDERICK CHARLE

Last Name

BURNHAM

Business Name

FREDERICK CHARLE BURNHAM

Original Issue Date

03/23/1983

Effective Date

09/13/2012

Expiration Date

09/30/2015

City

BETTENDORF

State

Zip

52722

County

IOWA

Ever Disciplined

LastModifiedDate

06/08/2015