WALTER BLAKE MADDOX Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019005931

License Status

NOT RENEWED

Business

First Name

WALTER BLAKE

Last Name

MADDOX

Business Name

WALTER BLAKE MADDOX

Original Issue Date

10/10/1929

Effective Date

10/10/1929

City

SHELL KNOB

State

Zip

65747

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/12/2005