BRADLEY S KOCH - Dentist License in Illinois | # 018000812

BRADLEY S KOCH

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000812

License Status

NOT RENEWED

Business

N

First Name

BRADLEY

Middle

S

Last Name

KOCH

Business Name

BRADLEY S KOCH

Original Issue Date

08/29/1994

Effective Date

08/29/1994

Expiration Date

06/30/1998

State

IL

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

N

LastModifiedDate

07/30/2018