SHANNON MARIE ALLEN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

ACTIVE

Business

Title

DMD

First Name

SHANNON

Middle

MARIE

Last Name

ALLEN

Business Name

SHANNON MARIE ALLEN DMD

Original Issue Date

08/07/2024

Effective Date

08/07/2024

Expiration Date

09/30/2027

City

SCOTT AIR FORCE BASE

State

Zip

62225

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/07/2024