CHAD RYAN STEWART DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

RYAN

Last Name

STEWART

Suffix

DMD

Business Name

CHAD RYAN STEWART DMD

Original Issue Date

05/15/2012

Effective Date

09/07/2012

Expiration Date

09/30/2015

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016