JEFFREY MICHAEL DOUGHERTY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025848

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

MICHAEL

Last Name

DOUGHERTY

Business Name

JEFFREY MICHAEL DOUGHERTY

Original Issue Date

06/10/2002

Effective Date

06/10/2002

Expiration Date

09/30/2004

City

O'FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/17/2005