CARLYLE MICKELSO MUNK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010028

License Status

NOT RENEWED

Business

First Name

CARLYLE MICKELSO

Last Name

MUNK

Suffix

DDS

Business Name

CARLYLE MICKELSO MUNK DDS

Original Issue Date

12/27/1951

Effective Date

12/27/1951

Expiration Date

09/30/1986

City

SALT LAKE CITY

State

Zip

84105

County

UTAH

Ever Disciplined

LastModifiedDate

10/12/2005