PHIL N RUCKMAN III Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002675

License Status

NOT RENEWED

Business

First Name

PHIL

Middle

Last Name

RUCKMAN III

Business Name

PHIL N RUCKMAN III

Original Issue Date

07/29/2015

Effective Date

10/21/2021

Expiration Date

09/30/2024

City

FORT WAYNE

State

Zip

46825

Specialty/Qualifier

ORAL AND MAXILLOFACIAL SURGERY

Ever Disciplined

LastModifiedDate

02/04/2025