HAROLD ANTHONY BLACK DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014522

License Status

INACTIVE

Business

First Name

HAROLD ANTHONY

Last Name

BLACK

Suffix

DDS

Business Name

HAROLD ANTHONY BLACK DDS

Original Issue Date

07/11/1973

Effective Date

07/11/1973

Expiration Date

09/30/2004

City

MCFARLAND

State

Zip

53558

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005