CLINT MATTHEW MARTIN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****07

License Status

NOT RENEWED

Business

First Name

CLINT

Middle

MATTHEW

Last Name

MARTIN

Suffix

DMD

Business Name

CLINT MATTHEW MARTIN DMD

Original Issue Date

04/02/2018

Effective Date

09/11/2021

Expiration Date

09/30/2024

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025