MICHELLE NICOLE HORST Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

NICOLE

Last Name

HORST

Business Name

MICHELLE NICOLE HORST

Original Issue Date

08/26/2013

Effective Date

08/26/2013

Expiration Date

09/30/2015

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016