MIRANDA MARIE BROWN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

NOT RENEWED

Business

Title

DDS

First Name

MIRANDA

Middle

MARIE

Last Name

BROWN

Business Name

MIRANDA MARIE BROWN DDS

Original Issue Date

07/29/2019

Effective Date

07/29/2019

Expiration Date

01/31/2022

City

FOND DU LAC

State

Zip

54935

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022