CLAY G VANDER WALL DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027465

License Status

INACTIVE

Business

First Name

CLAY

Middle

Last Name

VANDER WALL

Suffix

DDS

Business Name

CLAY G VANDER WALL DDS

Original Issue Date

07/13/2007

Effective Date

07/28/2009

Expiration Date

09/30/2012

City

MORRISVILLE

State

Zip

27560

Ever Disciplined

LastModifiedDate

06/06/2012