FORREST MORSHA FARR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

First Name

FORREST

Middle

MORSHA

Last Name

FARR

Business Name

FORREST MORSHA FARR

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

09/30/2006

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006