JEFFREY DAVID STALEY-HENNE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

ACTIVE

Business

First Name

JEFFREY

Middle

DAVID

Last Name

STALEY-HENNE

Suffix

DMD

Business Name

JEFFREY DAVID STALEY-HENNE DMD

Original Issue Date

07/20/2004

Effective Date

09/03/2024

Expiration Date

09/30/2027

City

PARIS

State

Zip

61944

County

EDGAR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/03/2024