EUGENE THEODORE KWIECIEN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013153

License Status

INACTIVE

Business

First Name

EUGENE THEODORE

Last Name

KWIECIEN

Suffix

DDS

Business Name

EUGENE THEODORE KWIECIEN DDS

Original Issue Date

07/20/1967

Effective Date

07/20/1967

Expiration Date

09/30/1990

City

LA PORTE

State

Zip

46350

County

INDIANA

Ever Disciplined

LastModifiedDate

10/12/2005