ROGER BLAIR WOODROME DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

First Name

ROGER BLAIR

Last Name

WOODROME

Suffix

DMD

Business Name

ROGER BLAIR WOODROME DMD

Original Issue Date

01/01/1998

Effective Date

10/09/2015

Expiration Date

09/30/2018

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018