PAUL MICHAEL BROADWATER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019019136

License Status

NOT RENEWED

Business

First Name

PAUL MICHAEL

Last Name

BROADWATER

Business Name

PAUL MICHAEL BROADWATER

Original Issue Date

08/02/1984

Effective Date

08/02/1984

Expiration Date

09/30/1988

City

SALT LAKE CITY

State

Zip

84117

County

UTAH

Ever Disciplined

LastModifiedDate

10/12/2005