STEPHEN THOMAS BLUE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

NOT RENEWED

Business

First Name

STEPHEN THOMAS

Last Name

BLUE

Suffix

DDS

Business Name

STEPHEN THOMAS BLUE DDS

Original Issue Date

01/01/1998

Effective Date

10/01/2015

Expiration Date

09/30/2018

City

GRIDLEY

State

Zip

61744

County

MCLEAN

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/31/2018