KEITH CLARENCE WINTERNHEIMER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****65

License Status

NOT RENEWED

Business

First Name

KEITH CLARENCE

Last Name

WINTERNHEIMER

Suffix

DDS

Business Name

KEITH CLARENCE WINTERNHEIMER DDS

Original Issue Date

12/08/1995

Effective Date

09/07/2012

Expiration Date

09/30/2015

City

GRAYVILLE

State

Zip

62844

County

WHITE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016