PHILIP RAY TRAVIS DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026333

License Status

INACTIVE

Business

First Name

PHILIP

Middle

RAY

Last Name

TRAVIS

Suffix

DMD

Business Name

PHILIP RAY TRAVIS DMD

Original Issue Date

01/15/2004

Effective Date

08/21/2015

Expiration Date

09/30/2018

City

FRANKFORT

State

Zip

40601

County

KENTUCKY

Ever Disciplined

LastModifiedDate

06/07/2018