PRESTON PAYGE STREET DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

ACTIVE

Business

Title

DMD

First Name

PRESTON

Middle

PAYGE

Last Name

STREET

Business Name

PRESTON PAYGE STREET DMD

Original Issue Date

06/24/2022

Effective Date

08/27/2024

Expiration Date

09/30/2027

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/27/2024