KEITH ANTONIO SALVATORI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

ANTONIO

Last Name

SALVATORI

Suffix

DMD

Business Name

KEITH ANTONIO SALVATORI DMD

Original Issue Date

12/29/2010

Effective Date

12/20/2016

Expiration Date

09/30/2018

City

REDMOND

State

Zip

98052

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018