JASON O SMITH DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

SMITH

Suffix

DMD

Business Name

JASON O SMITH DMD

Original Issue Date

07/30/1999

Effective Date

07/30/1999

Expiration Date

09/30/2002

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005