STEPHANIE LEE WHITLEY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000882

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

LEE

Last Name

WHITLEY

Suffix

DMD

Business Name

STEPHANIE LEE WHITLEY DMD

Original Issue Date

11/25/2013

Effective Date

07/09/2015

Expiration Date

09/30/2018

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

10/31/2018