MICHAEL E CORUM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

Last Name

CORUM

Business Name

MICHAEL E CORUM

Original Issue Date

08/28/2023

Effective Date

08/29/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62703

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/29/2024