CHARLES A FIFIELD JR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

NOT RENEWED

Business

First Name

CHARLES A

Last Name

FIFIELD JR

Business Name

CHARLES A FIFIELD JR

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005