SUSAN A STACKER DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024113

License Status

INACTIVE

Business

First Name

SUSAN A

Last Name

STACKER

Suffix

DDS

Business Name

SUSAN A STACKER DDS

Original Issue Date

03/06/1996

Effective Date

03/06/1996

Expiration Date

09/30/1998

City

APPLETON

State

Zip

54914

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005