ORDIE HERBERT KING JR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

NOT RENEWED

Business

First Name

ORDIE HERBERT

Last Name

KING JR

Suffix

DDS

Business Name

ORDIE HERBERT KING JR DDS

Original Issue Date

05/10/2007

Effective Date

08/06/2012

Expiration Date

09/30/2015

City

GODFREY

State

Zip

62035

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016