TARA MICHELE GRIFFIN DMD 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

TARA

Middle

MICHELE

Last Name

GRIFFIN

Suffix

DMD

Business Name

TARA MICHELE GRIFFIN DMD

Original Issue Date

06/29/1999

Effective Date

08/08/2012

Expiration Date

09/30/2015

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016