LARRY DAVID WHITE SR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

First Name

LARRY DAVID

Last Name

WHITE SR

Business Name

LARRY DAVID WHITE SR

Original Issue Date

09/04/1986

Effective Date

09/04/1986

Expiration Date

09/30/2006

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006