SAM EDWARD FARISH DMD - Dentist License in Missouri | # 136000011

SAM EDWARD FARISH DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000011

License Status

NOT RENEWED

Business

N

First Name

SAM EDWARD

Last Name

FARISH

Suffix

DMD

Business Name

SAM EDWARD FARISH DMD

Original Issue Date

01/03/1991

Effective Date

01/03/1991

Expiration Date

01/02/1993

State

MO

Ever Disciplined

N

LastModifiedDate

10/13/2005