KALEB BLAINE SHUMARD DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

ACTIVE

Business

Title

DMD

First Name

KALEB

Middle

BLAINE

Last Name

SHUMARD

Business Name

KALEB BLAINE SHUMARD DMD

Original Issue Date

06/10/2025

Effective Date

06/10/2025

Expiration Date

09/30/2027

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2025