THOMAS J BORMANN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000526

License Status

INACTIVE

Business

First Name

THOMAS J

Last Name

BORMANN

Suffix

DDS

Business Name

THOMAS J BORMANN DDS

Original Issue Date

06/22/2001

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

MICHIGAN CITY

State

Zip

46360

County

INDIANA

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

06/04/2009