YVONNE MARIE BALTHAZAR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

NOT RENEWED

Business

First Name

YVONNE MARIE

Last Name

BALTHAZAR

Suffix

DDS

Business Name

YVONNE MARIE BALTHAZAR DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1988

City

KENOSHA

State

Zip

53140

County

WISCONSIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005