DAVID MATTHEW FAIRCHILD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018945

License Status

NOT RENEWED

Business

First Name

DAVID MATTHEW

Last Name

FAIRCHILD

Business Name

DAVID MATTHEW FAIRCHILD

Original Issue Date

01/17/1984

Effective Date

01/17/1984

Expiration Date

09/30/2002

City

SOUTH BEND

State

Zip

46617

County

INDIANA

Ever Disciplined

LastModifiedDate

10/17/2005