EDWIN BURNELL PROBASCO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019000700

License Status

NOT RENEWED

Business

First Name

EDWIN BURNELL

Last Name

PROBASCO

Business Name

EDWIN BURNELL PROBASCO

Original Issue Date

06/29/1910

Effective Date

06/29/1910

City

SPARTA

State

Zip

62286

County

RANDOLPH

Ever Disciplined

LastModifiedDate

10/12/2005