SUZANNE D HASLETT Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

ACTIVE

Business

First Name

SUZANNE

Middle

Last Name

HASLETT

Business Name

SUZANNE D HASLETT

Original Issue Date

10/31/2018

Effective Date

08/15/2024

Expiration Date

09/30/2027

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II IV V

Ever Disciplined

LastModifiedDate

08/15/2024