DAVID L CLEMENS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

CLEMENS

Suffix

DDS

Business Name

DAVID L CLEMENS DDS

Original Issue Date

10/10/1983

Effective Date

10/10/1983

Expiration Date

09/30/1988

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/13/2005