ANTHONY RHODEN CLARK DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

First Name

ANTHONY

Middle

RHODEN

Last Name

CLARK

Suffix

DMD

Business Name

ANTHONY RHODEN CLARK DMD

Original Issue Date

03/14/2006

Effective Date

03/14/2006

Expiration Date

09/30/2006

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

11/08/2006