STEPHANIE LEE WHITLEY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

LEE

Last Name

WHITLEY

Suffix

DMD

Business Name

STEPHANIE LEE WHITLEY DMD

Original Issue Date

11/03/2010

Effective Date

07/15/2015

Expiration Date

09/30/2018

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/31/2018