License Type:
Dentist
License Number:
2901019992
Name:
Danielle Thea Muckenthaler
License Issue Date:
05/21/2009
License Expiration Date:
05/21/2026
License Status:
Active - In Late Renewal
County:
Macomb
City:
Bristol
State or Province:
Wisconsin
ZIP or Postal Code:
53104
CS Record Number:
5315222729
CS Status:
Lapsed
CS Expiration Date:
05/21/2023