JASON MANTLE KOCH DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025214

License Status

INACTIVE

Business

First Name

JASON

Middle

MANTLE

Last Name

KOCH

Suffix

DMD

Business Name

JASON MANTLE KOCH DMD

Original Issue Date

02/22/2000

Effective Date

02/22/2000

Expiration Date

09/30/2002

City

PADUCAH

State

Zip

42003

County

KENTUCKY

Ever Disciplined

LastModifiedDate

10/17/2005