LATASHA NICOLE NASH 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

LATASHA

Middle

NICOLE

Last Name

NASH

Suffix

DMD

Business Name

LATASHA NICOLE NASH DMD

Original Issue Date

12/21/2011

Effective Date

09/27/2012

Expiration Date

09/30/2015

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016