KENNETH EUGENE BEACH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****64

License Status

NOT RENEWED

Business

First Name

KENNETH EUGENE

Last Name

BEACH DDS

Business Name

KENNETH EUGENE BEACH DDS

Original Issue Date

08/19/1987

Effective Date

08/19/1987

Expiration Date

09/30/1990

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005