BRUCE WALDO SHRIVER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

First Name

BRUCE

Middle

WALDO

Last Name

SHRIVER

Suffix

DDS

Business Name

BRUCE WALDO SHRIVER DDS

Original Issue Date

01/01/1998

Effective Date

09/28/2012

Expiration Date

09/30/2015

City

PRINCETON

State

Zip

61356

County

BUREAU

Controlled Substance Schedule

IV V

Ever Disciplined

LastModifiedDate

02/08/2016