DAVID B SPONG 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

DAVID B

Last Name

SPONG

Business Name

DAVID B SPONG

Original Issue Date

09/27/1983

Effective Date

09/27/1983

Expiration Date

09/30/1992

City

OSWEGO

State

Zip

60543

County

KENDALL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005