FRED LEE WHITLATCH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

NOT RENEWED

Business

First Name

FRED LEE

Last Name

WHITLATCH

Business Name

FRED LEE WHITLATCH

Original Issue Date

08/26/1982

Effective Date

06/25/2012

Expiration Date

09/30/2015

City

WEST FRANKFORT

State

Zip

62896

County

FRANKLIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016