SAMANTHA KAY GROSS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

ACTIVE

Business

Title

DMD

First Name

SAMANTHA

Middle

KAY

Last Name

GROSS

Business Name

SAMANTHA KAY GROSS DMD

Original Issue Date

07/02/2022

Effective Date

07/03/2024

Expiration Date

09/30/2027

City

DU QUOIN

State

Zip

62832

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/03/2024