HEATHER L SURRATT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

Last Name

SURRATT

Suffix

DDS

Business Name

HEATHER L SURRATT DDS

Original Issue Date

08/09/2005

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012