TARAH ANN RIDENBARK DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030725

License Status

NOT RENEWED

Business

Title

DMD

First Name

TARAH

Middle

ANN

Last Name

RIDENBARK

Business Name

TARAH ANN RIDENBARK DMD

Original Issue Date

06/16/2016

Effective Date

06/16/2016

Expiration Date

09/30/2018

City

WORDEN

State

Zip

62097

County

MADISON

Ever Disciplined

LastModifiedDate

10/31/2018