KATIE REBEKAH KICKERTZ DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****65

License Status

NOT RENEWED

Business

Title

DDS

First Name

KATIE

Middle

REBEKAH

Last Name

KICKERTZ

Business Name

KATIE REBEKAH KICKERTZ DDS

Original Issue Date

09/28/2012

Effective Date

09/16/2015

Expiration Date

09/30/2018

City

CHARLOTTE

State

Zip

28277

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018