Utah
Division of Occupational and Professional Licensing
KEITH ALLEN VAN TASSELL
Dental - Dentist Anesthesia Class Iii Permit
License number
7115035-9923
Date granted
09/23/2008
Date expires
05/31/2012
Class
Dental - Dentist Anesthesia Class Iii Permit
Status
Expired
Address
FORT COLLINS, CO 805289490
utahlicensing.org
ID 29719797
LAST UPDATED 2024-03-08 17:01:52 UTC
LAST UPDATED 2024-03-08 17:01:52 UTC
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