ROGER EDWIN SULLIVAN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010343

License Status

INACTIVE

Business

First Name

ROGER EDWIN

Last Name

SULLIVAN

Suffix

DDS

Business Name

ROGER EDWIN SULLIVAN DDS

Original Issue Date

08/06/1953

Effective Date

08/06/1953

Expiration Date

09/30/1992

City

SALEM

State

Zip

24153

County

VIRGINIA

Ever Disciplined

LastModifiedDate

10/12/2005