SAMUEL THOMAS DEAHL II DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****10

License Status

NOT RENEWED

Business

First Name

SAMUEL THOMAS

Last Name

DEAHL II

Suffix

DMD

Business Name

SAMUEL THOMAS DEAHL II DMD

Original Issue Date

01/01/1998

Expiration Date

09/30/1984

City

SPARTA

State

Zip

62286

County

RANDOLPH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005