MARY KATHERINE BOOTH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****33

License Status

NOT RENEWED

Business

First Name

MARY

Middle

KATHERINE

Last Name

BOOTH

Business Name

MARY KATHERINE BOOTH

Original Issue Date

06/05/2009

Effective Date

10/22/2021

Expiration Date

09/30/2024

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025