DAVID BRADFORD RODENBERG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

NOT RENEWED

Business

First Name

DAVID BRADFORD

Last Name

RODENBERG

Suffix

DDS

Business Name

DAVID BRADFORD RODENBERG DDS

Original Issue Date

11/14/1983

Effective Date

09/30/2009

Expiration Date

09/30/2012

City

COLUMBIA

State

Zip

62236

County

MONROE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012