STEPHEN PIERCE FORSYTH 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

STEPHEN

Middle

PIERCE

Last Name

FORSYTH

Suffix

DMD

Business Name

STEPHEN PIERCE FORSYTH DMD

Original Issue Date

06/28/2019

Effective Date

09/11/2021

Expiration Date

09/30/2024

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025