DANIEL PHILIP URBAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011284

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

PHILIP

Last Name

URBAN

Suffix

DDS

Business Name

DANIEL PHILIP URBAN DDS

Original Issue Date

08/11/1958

Effective Date

07/30/2009

Expiration Date

09/30/2012

City

FORT WAYNE

State

Zip

46804

County

INDIANA

Ever Disciplined

LastModifiedDate

11/14/2012