ROBERT EDMUND SMITH DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

CANCELLED

Business

First Name

ROBERT EDMUND

Last Name

SMITH

Suffix

DDS

Business Name

ROBERT EDMUND SMITH DDS

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

ARCOLA

State

Zip

61910

County

DOUGLAS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2009