ADAM SCOTT FRITZGERALD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

ACTIVE

Business

First Name

ADAM

Middle

SCOTT

Last Name

FRITZGERALD

Business Name

ADAM SCOTT FRITZGERALD

Original Issue Date

06/10/2015

Effective Date

07/22/2024

Expiration Date

09/30/2027

City

DECATUR

State

Zip

62526

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2024