BRYAN FORREST PACKARD DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030304

License Status

NOT RENEWED

Business

Title

DMD

First Name

BRYAN

Middle

FORREST

Last Name

PACKARD

Business Name

BRYAN FORREST PACKARD DMD

Original Issue Date

07/16/2015

Effective Date

07/16/2015

Expiration Date

09/30/2018

City

LOUISVILLE

State

Zip

40245

County

KENTUCKY

Ever Disciplined

LastModifiedDate

10/31/2018