HENRY JOE TAGLE DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

NOT RENEWED

Business

First Name

HENRY

Middle

JOE

Last Name

TAGLE

Suffix

DMD

Business Name

HENRY JOE TAGLE DMD

Original Issue Date

05/29/2003

Effective Date

05/29/2003

Expiration Date

09/30/2006

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2007