JERRY LEE TODD DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012588

License Status

INACTIVE

Business

First Name

JERRY LEE

Last Name

TODD

Suffix

DDS

Business Name

JERRY LEE TODD DDS

Original Issue Date

07/14/1964

Effective Date

07/14/1964

Expiration Date

09/30/2004

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

10/17/2005