MOLLY ELIZABETH STICE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

ACTIVE

Business

First Name

MOLLY

Middle

ELIZABETH

Last Name

STICE

Business Name

MOLLY ELIZABETH STICE

Original Issue Date

06/05/2017

Effective Date

08/13/2024

Expiration Date

09/30/2027

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024