CHARLES CLARK WILLHITE DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****42

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

CLARK

Last Name

WILLHITE

Suffix

DMD

Business Name

CHARLES CLARK WILLHITE DMD

Original Issue Date

01/11/2002

Effective Date

09/05/2012

Expiration Date

09/30/2015

City

DECATUR

State

Zip

62521

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016