DARRICK LAVONE CASTLEBERRY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

NOT RENEWED

Business

First Name

DARRICK LAVONE

Last Name

CASTLEBERRY

Suffix

DDS

Business Name

DARRICK LAVONE CASTLEBERRY DDS

Original Issue Date

03/25/1996

Effective Date

03/25/1996

Expiration Date

09/30/1996

City

GREAT LAKES

State

Zip

60088

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005