EDDIE KIYOSHI BROTKOWSKI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028722

License Status

NOT RENEWED

Business

Title

DDS

First Name

EDDIE

Middle

KIYOSHI

Last Name

BROTKOWSKI

Business Name

EDDIE KIYOSHI BROTKOWSKI DDS

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

09/30/2012

City

WEST PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

11/14/2012