| Requirement Code | Complied? | Complied Date |
| Renewal Requirements for the year: 2021 | ||
| CPR | requirement complied | 09/13/2021 |
| FEE | requirement complied | 09/13/2021 |
| SIG | requirement complied | 09/13/2021 |
Individual Search Results - Detail
Credential/License Summary for 3863
Name: KOCH, BRIAN D
Profession: DENTISTRY (15)
Credential/License Number: 3863-15
Location: GREEN BAY WI
Credential/License Type: regular
Status: License is not current (Expired)
Eligible To Practice: Not Eligible to Practice
Credential/License current through: 9/30/2023
Granted date: 9/15/1987
Multi-state: N
Orders: NONE
Specialties: Sedation I
Other Names:
Brian D Koch
| Renewal Year | Amount Paid | Payment Received |
| 2021 | 60 | 09/13/2021 |
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ATTENTION: If a renewal application including payment is received by the renew by date (or Credential/License current through date), the credential holder is eligible to practice while the credential renewal is being processed. The credential holder must respond to any requests for information during the renewal process. See Wis. Stat. ยง 227.51(2).
