RICHARD L GREEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****60

License Status

NOT RENEWED

Business

First Name

RICHARD L

Last Name

GREEN

Suffix

DDS

Business Name

RICHARD L GREEN DDS

Original Issue Date

12/15/1995

Effective Date

12/15/1995

Expiration Date

09/30/1996

City

DUPO

State

Zip

62239

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005