GERALD MOORE CLARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019009257

License Status

NOT RENEWED

Business

First Name

GERALD MOORE

Last Name

CLARK

Suffix

DDS

Business Name

GERALD MOORE CLARK DDS

Original Issue Date

08/04/1947

Effective Date

08/04/1947

Expiration Date

09/30/1984

City

POCATELLO

State

Zip

83201

County

IDAHO

Ever Disciplined

LastModifiedDate

10/12/2005