MICHELLE N DACOSTA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019023837

License Status

NOT RENEWED

Business

First Name

MICHELLE N

Last Name

DACOSTA

Suffix

DDS

Business Name

MICHELLE N DACOSTA DDS

Original Issue Date

04/05/1995

Effective Date

04/05/1995

Expiration Date

09/30/1998

City

MILWAUKEE

State

Zip

53233

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005