LARRY J SMALL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

NOT RENEWED

Business

First Name

LARRY

Middle

Last Name

SMALL

Business Name

LARRY J SMALL

Original Issue Date

08/19/1987

Effective Date

08/19/1987

Expiration Date

09/30/1988

City

CENTREVILLE

State

Zip

62207

County

SAINT CLAIR

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/13/2005