CHARLES D CONLEY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

Last Name

CONLEY

Suffix

DMD

Business Name

CHARLES D CONLEY DMD

Original Issue Date

12/13/2005

Effective Date

12/13/2005

Expiration Date

09/30/2006

City

EAST ALTON

State

Zip

62024

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006