DAVID MYERS SMITH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

NOT RENEWED

Business

First Name

DAVID MYERS

Last Name

SMITH

Suffix

DDS

Business Name

DAVID MYERS SMITH DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2000

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

10/17/2005