ANDREW TYLER CUPP DMD - Dentist License in Georgia | # 31*****32

ANDREW TYLER CUPP DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****32

License Status

NOT RENEWED

Business

N

Title

DMD

First Name

ANDREW

Middle

TYLER

Last Name

CUPP

Business Name

ANDREW TYLER CUPP DMD

Original Issue Date

05/25/2016

Effective Date

05/25/2016

Expiration Date

09/30/2018

State

GA

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

10/31/2018