SAMANTHA LYNN HOLDER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****44

License Status

NOT RENEWED

Business

Title

DDS

First Name

SAMANTHA

Middle

LYNN

Last Name

HOLDER

Business Name

SAMANTHA LYNN HOLDER DDS

Original Issue Date

08/31/2007

Effective Date

10/01/2015

Expiration Date

09/30/2018

City

MOKENA

State

Zip

60448

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018