TRUSTEN POLK LEE III DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014344

License Status

NOT RENEWED

Business

First Name

TRUSTEN POLK

Last Name

LEE III

Suffix

DDS

Business Name

TRUSTEN POLK LEE III DDS

Original Issue Date

07/12/1972

Effective Date

06/29/2009

Expiration Date

09/30/2012

City

ROCKVILLE

State

Zip

47872

County

INDIANA

Ever Disciplined

LastModifiedDate

11/14/2012