RICHARD KIETH WALTER DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012278

License Status

INACTIVE

Business

First Name

RICHARD KIETH

Last Name

WALTER

Suffix

DDS

Business Name

RICHARD KIETH WALTER DDS

Original Issue Date

07/25/1963

Effective Date

07/25/1963

Expiration Date

09/30/1996

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/12/2005