DAVID D DALISE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012681

License Status

NOT RENEWED

Business

First Name

DAVID D

Last Name

DALISE

Suffix

DDS

Business Name

DAVID D DALISE DDS

Original Issue Date

07/15/1965

Effective Date

07/15/1965

Expiration Date

09/30/2000

City

ALBUQUERQUE

State

Zip

87123

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

10/17/2005