DOUGLAS JACK WHITE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

ACTIVE

Business

First Name

DOUGLAS JACK

Last Name

WHITE

Suffix

DMD

Business Name

DOUGLAS JACK WHITE DMD

Original Issue Date

01/01/1998

Effective Date

05/06/2024

Expiration Date

09/30/2027

City

PITTSFIELD

State

Zip

62363

County

PIKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2024