LARRY WALLACE MIZELLE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019020062

License Status

NOT RENEWED

Business

First Name

LARRY WALLACE

Last Name

MIZELLE

Business Name

LARRY WALLACE MIZELLE

Original Issue Date

06/04/1986

Effective Date

06/04/1986

Expiration Date

09/30/2004

City

TEMPERANCE

State

Zip

48182

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/17/2005