JEFFREY CARSON WHITESIDE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

ACTIVE

Business

First Name

JEFFREY

Middle

CARSON

Last Name

WHITESIDE

Business Name

JEFFREY CARSON WHITESIDE

Original Issue Date

07/27/2009

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024