NILES WALTER HERROD DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012250

License Status

INACTIVE

Business

First Name

NILES WALTER

Last Name

HERROD

Suffix

DDS

Business Name

NILES WALTER HERROD DDS

Original Issue Date

07/25/1963

Effective Date

07/25/1963

Expiration Date

09/30/1990

City

PROVO

State

Zip

84601

County

UTAH

Ever Disciplined

LastModifiedDate

10/12/2005