LARRY D SHAPIRO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

Title

DMD

First Name

LARRY

Middle

Last Name

SHAPIRO

Business Name

LARRY D SHAPIRO DMD

Original Issue Date

06/13/2005

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009