KEITH A STUMMER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027259

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

Last Name

STUMMER

Business Name

KEITH A STUMMER

Original Issue Date

12/18/2006

Effective Date

12/18/2006

Expiration Date

09/30/2009

City

PLEASANT PRAIRIE

State

Zip

53158

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/08/2010