KOURTNEY PAIGE STOMBAUGH DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

ACTIVE

Business

Title

DMD

First Name

KOURTNEY

Middle

PAIGE

Last Name

STOMBAUGH

Business Name

KOURTNEY PAIGE STOMBAUGH DMD

Original Issue Date

06/30/2021

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/28/2024