License holder summary

KEITH BROCKBANK MEDLEY is a Dental - Dentist Anesthesia Class I Permit licensed to practice in Utah. The address on file for KEITH BROCKBANK MEDLEY is COVINA, CA 91722. This licensed professional license is not current. The license was granted 01/01/1910 and expired on 05/31/2006.

Utah

Division of Occupational and Professional Licensing

KEITH BROCKBANK MEDLEY
Dental - Dentist Anesthesia Class I Permit
License number
124575-9921
Date granted
01/01/1910
Date expires
05/31/2006
Class
Dental - Dentist Anesthesia Class I Permit
Status
Expired
Address
COVINA, CA 91722
utahlicensing.org
ID 29716149
LAST UPDATED 2024-06-05 17:09:11 UTC

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