MICHAEL TERRY KIRKWOOD DDS Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

INOPERATIVE

Business

First Name

MICHAEL TERRY

Last Name

KIRKWOOD

Suffix

DDS

Business Name

MICHAEL TERRY KIRKWOOD DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2000

City

LAWRENCEVILLE

State

Zip

62439

County

LAWRENCE

Controlled Substance Schedule

II IV

Ever Disciplined

LastModifiedDate

10/13/2005