MALCOLM R BERG Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019020860

License Status

INACTIVE

Business

First Name

MALCOLM R

Last Name

BERG

Business Name

MALCOLM R BERG

Original Issue Date

09/29/1987

Effective Date

09/29/1987

Expiration Date

09/30/1994

City

WARRENSBURG

State

Zip

64093

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/12/2005