GERALD WAYNE BURKETT Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010071

License Status

INACTIVE

Business

First Name

GERALD WAYNE

Last Name

BURKETT

Business Name

GERALD WAYNE BURKETT

Original Issue Date

08/18/1952

Effective Date

08/18/1952

Expiration Date

09/30/2000

City

MT. CARMEL

State

Zip

62863

County

WABASH

Ever Disciplined

LastModifiedDate

10/17/2005