ERIC SCOTT BROCKMAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021003142

License Status

NOT RENEWED

Business

Title

DMD

First Name

ERIC

Middle

SCOTT

Last Name

BROCKMAN

Business Name

ERIC SCOTT BROCKMAN DMD

Original Issue Date

10/05/2021

Effective Date

10/05/2021

Expiration Date

09/30/2024

City

MADISON

State

Zip

53704

Specialty/Qualifier

PERIODONTICS

Ever Disciplined

LastModifiedDate

02/04/2025