KENNETH BRYAN SCROGGINS 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

KENNETH

Middle

BRYAN

Last Name

SCROGGINS

Business Name

KENNETH BRYAN SCROGGINS DMD

Original Issue Date

02/22/2012

Effective Date

02/22/2012

Expiration Date

09/30/2012

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012