JAMES T FETSCH DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000814

License Status

NOT RENEWED

Business

First Name

JAMES

Middle

Last Name

FETSCH

Suffix

DMD

Business Name

JAMES T FETSCH DMD

Original Issue Date

06/22/2011

Effective Date

07/07/2016

Expiration Date

09/30/2018

City

HIGHLAND

State

Zip

62249

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

10/31/2018