TSBDE Dentist: HERZOG, CLINTON F. # 20239
| License Number | 20239 |
| License Rank | Licensed Dentist |
| License Status | Vol Surrender |
| License Issue Date | 07/12/2000 |
| License Expiration Date | 08/31/2016 |
| Electronic Rx Waiver Expiration Date |
| Last Name | HERZOG |
| Former Last Name | HERZOG |
| First Name | CLINTON |
| Middle Name | F. |
| Gender | Male | City | AUSTIN |
| State | TX |
| Zip Code | 78757 |
| County | TRAVIS |
| Exempt Location | No |
| Nitrous Certification Date | 11/10/2000 |
| Anesthesia Level 1 Permit Issue Date | No Permit |
| Anesthesia Level 2 Permit Issue Date | No Permit |
| Anesthesia Level 3 Permit Issue Date | No Permit |
| Anesthesia Level 4 Permit Issue Date | No Permit |
| Sedation of Pediatric Patients | No |
| Sedation of High-Risk Patients | No |
| Type of Practice | GEN |
| Year Graduated | 2000 |
| Dental School | UTSA |
| Year of Birth | 1974 |
| Public Actions | |||
| Disciplinary Action | Yes | ||
| Disciplinary Action PDFs | 20239_Herzog_Clinton_04-15-2011.pdf - | 20239_Herzog_Clinton_08-14-2015.pdf - | 20239_Herzog_Clinton_08-24-2016.pdf - |
| Remedial Plans | Yes | ||
| Remedial Plan PDFs | 20239_HERZOG_Clinton_06-03-2016.pdf - |
CERTIFICATION OF INFORMATION: The Texas State Board of Dental Examiners certifies that it maintains the information for the license verification functions of this website, performs daily updates to the website and considers the website to be a secure, primary source for license verification.
Exempt Location status applies to dentists who hold at least a level 2 sedation permit or higher. Pursuant to Board Rule 110.18(g): Exempt-location status: During the period of exempt-location status, a permit holder may not delegate the administration of any level of sedation/anesthesia to a dental or medical professional outside a state-licensed hospital or state-licensed ambulatory surgery center. If they are later found to have administered or delegated the administration of level 2, 3, or 4 sedation/anesthesia in a non-exempt location, the Board shall pursue revocation of their dental license.
Codes for Type of Practice
DPH=Dental Public HealthEND=Endodontics
GEN=General Dentistry
OMP=Oral&Maxillofacial Pathology
OMR=Oral&Maxillofacial Radiology
OMS=Oral&Maxillofacial Surgery
ORTH=Orthodontics
PEDO=Pediatric Dentistry
PERI=Periodontics
PROS=Prosthodontics