ROBERT LAWRENCE LARISON 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

ROBERT LAWRENCE

Last Name

LARISON

Business Name

ROBERT LAWRENCE LARISON

Original Issue Date

09/17/1984

Effective Date

09/17/1984

Expiration Date

09/30/1988

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005