KENNETH J EVANS DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

INACTIVE

Business

First Name

KENNETH J

Last Name

EVANS

Suffix

DDS

Business Name

KENNETH J EVANS DDS

Original Issue Date

01/01/1998

Effective Date

08/18/2009

Expiration Date

09/30/2012

City

HAVANA

State

Zip

62644

County

MASON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/06/2012