ROGER ERNEST GRUA DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014572

License Status

INACTIVE

Business

First Name

ROGER

Middle

ERNEST

Last Name

GRUA

Suffix

DDS

Business Name

ROGER ERNEST GRUA DDS

Original Issue Date

07/11/1973

Effective Date

09/10/2007

Expiration Date

09/30/2009

City

OGDEN

State

Zip

84403

Ever Disciplined

LastModifiedDate

06/04/2009