KIM LAWRENCE BROKAW Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018857

License Status

ACTIVE

Business

First Name

KIM LAWRENCE

Last Name

BROKAW

Business Name

KIM LAWRENCE BROKAW

Original Issue Date

10/03/1983

Effective Date

09/12/2024

Expiration Date

09/30/2027

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

09/12/2024