AMY R GROELTZ DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

GROELTZ

Suffix

DDS

Business Name

AMY R GROELTZ DDS

Original Issue Date

08/19/2004

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

BIGGSVILLE

State

Zip

61418

County

HENDERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009