LARRY KENNETH MACON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

First Name

LARRY KENNETH

Last Name

MACON

Suffix

DMD

Business Name

LARRY KENNETH MACON DMD

Original Issue Date

01/01/1998

Effective Date

06/09/2009

Expiration Date

09/30/2012

City

MOUNT STERLING

State

Zip

62353

County

BROWN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012