NICOLE ALEXANDRA SMITH DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

ACTIVE

Business

First Name

NICOLE

Middle

ALEXANDRA

Last Name

SMITH

Suffix

DMD

Business Name

NICOLE ALEXANDRA SMITH DMD

Original Issue Date

10/14/2021

Effective Date

08/12/2024

Expiration Date

09/30/2027

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/12/2024