RICHARD KIETH WALTER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

NOT RENEWED

Business

First Name

RICHARD KIETH

Last Name

WALTER

Suffix

DDS

Business Name

RICHARD KIETH WALTER DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

ROCKFORD

State

Zip

61107

County

BOONE

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

10/13/2005