TIMOTHY WAYNE ROSER DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

ACTIVE

Business

First Name

TIMOTHY

Middle

WAYNE

Last Name

ROSER

Suffix

DMD

Business Name

TIMOTHY WAYNE ROSER DMD

Original Issue Date

06/15/2005

Effective Date

08/29/2024

Expiration Date

09/30/2027

City

CARMI

State

Zip

62821

County

WHITE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/29/2024