MALCOLM KEITH LEWIS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014445

License Status

NOT RENEWED

Business

First Name

MALCOLM KEITH

Last Name

LEWIS

Suffix

DDS

Business Name

MALCOLM KEITH LEWIS DDS

Original Issue Date

07/12/1972

Effective Date

07/12/1972

Expiration Date

09/30/1988

City

INDIANAPOLIS

State

Zip

46204

County

INDIANA

Ever Disciplined

LastModifiedDate

10/12/2005