DENNIS BRUCE DAVIS DMD Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001395

License Status

EXPIRED

Business

First Name

DENNIS

Middle

BRUCE

Last Name

DAVIS

Suffix

DMD

Business Name

DENNIS BRUCE DAVIS DMD

Original Issue Date

05/20/2003

Effective Date

05/20/2003

Expiration Date

06/30/2004

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005