SCOTT A ERICKSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019016995

License Status

NOT RENEWED

Business

First Name

SCOTT A

Last Name

ERICKSON

Suffix

DDS

Business Name

SCOTT A ERICKSON DDS

Original Issue Date

10/17/1979

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/08/2006