RICHARD KEITH USEDOM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018382

License Status

ACTIVE

Business

First Name

RICHARD KEITH

Last Name

USEDOM

Business Name

RICHARD KEITH USEDOM

Original Issue Date

10/05/1982

Effective Date

08/02/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

08/02/2024