KEITH DOUGLASS RICE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****44

License Status

ACTIVE

Business

First Name

KEITH

Middle

DOUGLASS

Last Name

RICE

Business Name

KEITH DOUGLASS RICE

Original Issue Date

09/17/2018

Effective Date

07/31/2024

Expiration Date

09/30/2027

City

GLEN CARBON

State

Zip

62034

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/31/2024