GERALD LEE LARSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011731

License Status

NOT RENEWED

Business

First Name

GERALD LEE

Last Name

LARSON

Suffix

DDS

Business Name

GERALD LEE LARSON DDS

Original Issue Date

08/01/1960

Effective Date

08/01/1960

City

MADISON

State

Zip

53711

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005