TITUS J WONGK Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019031826

License Status

INACTIVE

Business

First Name

TITUS

Middle

Last Name

WONGK

Business Name

TITUS J WONGK

Original Issue Date

08/07/2018

Effective Date

08/07/2018

Expiration Date

12/31/2021

City

LOUISVILLE

State

Zip

40207

County

JEFFERSON

Ever Disciplined

LastModifiedDate

09/11/2021