HAROLD LEE MARTIN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

First Name

HAROLD LEE

Last Name

MARTIN

Business Name

HAROLD LEE MARTIN

Original Issue Date

01/01/1998

Effective Date

12/14/2006

Expiration Date

09/30/2009

City

FLORA

State

Zip

62839

County

CLAY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009