TIMOTHY A BACSA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026831

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

BACSA

Suffix

DDS

Business Name

TIMOTHY A BACSA DDS

Original Issue Date

07/21/2005

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

01/08/2010