LEAH BETH DAVIS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

ACTIVE

Business

Title

DMD

First Name

LEAH

Middle

BETH

Last Name

DAVIS

Business Name

LEAH BETH DAVIS DMD

Original Issue Date

04/15/2016

Effective Date

06/21/2024

Expiration Date

09/30/2027

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2024