RICKY KEN BIETHMAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019017372

License Status

NOT RENEWED

Business

First Name

RICKY

Middle

KEN

Last Name

BIETHMAN

Suffix

DMD

Business Name

RICKY KEN BIETHMAN DMD

Original Issue Date

07/30/1980

Effective Date

07/30/1980

Expiration Date

09/30/1988

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

09/02/2010