AVERY C POWELL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000487

License Status

NOT RENEWED

Business

First Name

AVERY

Middle

Last Name

POWELL

Suffix

DDS

Business Name

AVERY C POWELL DDS

Original Issue Date

07/26/1990

Effective Date

07/26/1990

Expiration Date

06/30/1991

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005