JEFFREY CHARLES FIFIELD DMD 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

JEFFREY CHARLES

Last Name

FIFIELD

Suffix

DMD

Business Name

JEFFREY CHARLES FIFIELD DMD

Original Issue Date

01/01/1998

Expiration Date

09/30/1998

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005