PRESTON PAYGE STREET DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019033734

License Status

ACTIVE

Business

Title

DMD

First Name

PRESTON

Middle

PAYGE

Last Name

STREET

Business Name

PRESTON PAYGE STREET DMD

Original Issue Date

06/08/2022

Effective Date

08/13/2024

Expiration Date

09/30/2027

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Ever Disciplined

LastModifiedDate

08/13/2024