SAMUEL R BRUNNER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019023847

License Status

NOT RENEWED

Business

First Name

SAMUEL R

Last Name

BRUNNER

Suffix

DDS

Business Name

SAMUEL R BRUNNER DDS

Original Issue Date

04/22/1995

Effective Date

04/22/1995

Expiration Date

09/30/1996

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/12/2005