ROBERT PAUL WIDERQUIST DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014505

License Status

NOT RENEWED

Business

First Name

ROBERT PAUL

Last Name

WIDERQUIST

Suffix

DDS

Business Name

ROBERT PAUL WIDERQUIST DDS

Original Issue Date

12/13/1972

Effective Date

12/13/1972

Expiration Date

09/30/1984

City

PORTAGE

State

Zip

53901

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005