BRADLEY S KOCH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000812

License Status

NOT RENEWED

Business

First Name

BRADLEY

Middle

Last Name

KOCH

Business Name

BRADLEY S KOCH

Original Issue Date

08/29/1994

Effective Date

08/29/1994

Expiration Date

06/30/1998

City

GREAT LAKES

State

Zip

60088

County

LAKE

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

LastModifiedDate

07/30/2018