GERUSA S MELLO-BURSTADT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000488

License Status

NOT RENEWED

Business

First Name

GERUSA S

Last Name

MELLO-BURSTADT

Suffix

DDS

Business Name

GERUSA S MELLO-BURSTADT DDS

Original Issue Date

11/19/1999

Effective Date

10/06/2015

Expiration Date

09/30/2018

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

10/31/2018