DAVID R DEFOREST DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

ACTIVE

Business

Title

DDS

First Name

DAVID

Middle

Last Name

DEFOREST

Business Name

DAVID R DEFOREST DDS

Original Issue Date

11/16/1990

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

OREGON

State

Zip

61061

County

OGLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2024