DOUGLAS MICHAEL HARTLEY 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

DOUGLAS

Middle

MICHAEL

Last Name

HARTLEY

Suffix

DDS

Business Name

DOUGLAS MICHAEL HARTLEY DDS

Original Issue Date

05/29/2012

Effective Date

09/16/2015

Expiration Date

09/30/2018

City

CASEY

State

Zip

62420

County

CLARK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/31/2018