DERRICK F ZIEMBA DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024620

License Status

INACTIVE

Business

First Name

DERRICK F

Last Name

ZIEMBA

Suffix

DMD

Business Name

DERRICK F ZIEMBA DMD

Original Issue Date

11/26/1997

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

LONG MEADOW

State

Zip

01106

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

07/24/2006