GERALD WAYNE BURKETT Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****32

License Status

NOT RENEWED

Business

First Name

GERALD WAYNE

Last Name

BURKETT

Business Name

GERALD WAYNE BURKETT

Original Issue Date

01/01/1998

Expiration Date

09/30/2000

City

MOUNT CARMEL

State

Zip

62863

County

EDWARDS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005