THEODORE LAWRENC WIERSMA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011773

License Status

NOT RENEWED

Business

First Name

THEODORE LAWRENC

Last Name

WIERSMA

Suffix

DDS

Business Name

THEODORE LAWRENC WIERSMA DDS

Original Issue Date

08/08/1960

Effective Date

08/08/1960

Expiration Date

09/30/1984

City

BROOMALL

State

Zip

19008

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

10/12/2005