CHARLES WAYNE ROBERTS DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

NOT RENEWED

Business

Title

DMD

First Name

CHARLES

Middle

WAYNE

Last Name

ROBERTS

Business Name

CHARLES WAYNE ROBERTS DMD

Original Issue Date

12/03/2015

Effective Date

12/03/2015

Expiration Date

09/30/2018

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018