KEVIN MICHAEL LANE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027978

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

MICHAEL

Last Name

LANE

Business Name

KEVIN MICHAEL LANE

Original Issue Date

06/05/2009

Effective Date

06/05/2009

Expiration Date

09/30/2012

City

GROSSE POINTE WOODS

State

Zip

48236

County

MICHIGAN

Ever Disciplined

LastModifiedDate

11/14/2012