HENRY J WIRTH Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019001427

License Status

CANCELLED

Business

First Name

HENRY J

Last Name

WIRTH

Business Name

HENRY J WIRTH

Original Issue Date

01/01/1998

City

EUREKA

State

Zip

61530

County

WOODFORD

Ever Disciplined

LastModifiedDate

10/12/2005