PHILLIP T MARUCHA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026595

License Status

NOT RENEWED

Business

First Name

PHILLIP

Middle

Last Name

MARUCHA

Suffix

DMD

Business Name

PHILLIP T MARUCHA DMD

Original Issue Date

09/27/2004

Effective Date

12/28/2021

Expiration Date

09/30/2024

City

PORTLAND

State

Zip

97201

County

OREGON

Ever Disciplined

LastModifiedDate

02/04/2025