JERRY LEE MARSHALL DMD 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

JERRY LEE

Last Name

MARSHALL

Suffix

DMD

Business Name

JERRY LEE MARSHALL DMD

Original Issue Date

01/01/1998

Effective Date

07/19/2018

Expiration Date

01/31/2022

City

BETHALTO

State

Zip

62010

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022