SCOTT MILES CONDIE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

Title

DDS

First Name

SCOTT

Middle

MILES

Last Name

CONDIE

Business Name

SCOTT MILES CONDIE DDS

Original Issue Date

09/14/2000

Effective Date

09/09/2009

Expiration Date

09/30/2012

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012