PAUL DOUGLAS DAVIS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****39

License Status

NOT RENEWED

Business

First Name

PAUL DOUGLAS

Last Name

DAVIS

Suffix

DDS

Business Name

PAUL DOUGLAS DAVIS DDS

Original Issue Date

01/01/1998

Effective Date

06/19/2012

Expiration Date

09/30/2015

City

PETERSBURG

State

Zip

62675

County

MENARD

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

02/08/2016