KEITH D DAVIS DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013586

License Status

INACTIVE

Business

First Name

KEITH D

Last Name

DAVIS

Suffix

DDS

Business Name

KEITH D DAVIS DDS

Original Issue Date

07/14/1969

Effective Date

07/14/1969

Expiration Date

09/30/1990

City

BROOKFIELD

State

Zip

53005

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005