DANIEL KIM CASSITY DMD Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

INOPERATIVE

Business

First Name

DANIEL

Middle

KIM

Last Name

CASSITY

Suffix

DMD

Business Name

DANIEL KIM CASSITY DMD

Original Issue Date

10/16/1998

Effective Date

10/16/1998

Expiration Date

09/30/2002

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005