CHARLES F MATTINGLY III DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****66

License Status

NOT RENEWED

Business

First Name

CHARLES F

Last Name

MATTINGLY III

Suffix

DDS

Business Name

CHARLES F MATTINGLY III DDS

Original Issue Date

01/31/1991

Effective Date

01/31/1991

Expiration Date

09/30/1992

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005