DAVID MATTHEW FAIRCHILD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

First Name

DAVID MATTHEW

Last Name

FAIRCHILD

Business Name

DAVID MATTHEW FAIRCHILD

Original Issue Date

02/08/1984

Effective Date

02/08/1984

Expiration Date

09/30/1986

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005