License holder summary

GRANT CLAYSON BROCKBANK is a Dental - Dentist Anesthesia Class I Permit licensed to practice in Utah. The address on file for GRANT CLAYSON BROCKBANK is SALT LAKE CITY, UT 841082616. This licensed professional license is not current. The license was granted 07/02/1959 and expired on 05/31/2014.

Utah

Division of Occupational and Professional Licensing

GRANT CLAYSON BROCKBANK
Dental - Dentist Anesthesia Class I Permit
License number
127481-9921
Date granted
07/02/1959
Date expires
05/31/2014
Class
Dental - Dentist Anesthesia Class I Permit
Status
Expired
Address
SALT LAKE CITY, UT 841082616
utahlicensing.org
ID 29715713
LAST UPDATED 2024-04-16 19:18:22 UTC

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