License holder summary

ALLEN BRENT BROCKBANK is a Dental - Dentist Anesthesia Class I Permit licensed to practice in Utah. The address on file for ALLEN BRENT BROCKBANK is SAN JOSE, CA 95126. This licensed professional license is not current. The license was granted 01/01/1910 and expired on 05/31/1996.

Utah

Division of Occupational and Professional Licensing

ALLEN BRENT BROCKBANK
Dental - Dentist Anesthesia Class I Permit
License number
130964-9921
Date granted
01/01/1910
Date expires
05/31/1996
Class
Dental - Dentist Anesthesia Class I Permit
Status
Expired
Address
SAN JOSE, CA 95126
utahlicensing.org
ID 29714919
LAST UPDATED 2024-04-02 15:32:01 UTC

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