KEITH A BRYANT DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

ACTIVE

Business

First Name

KEITH A

Last Name

BRYANT

Suffix

DMD

Business Name

KEITH A BRYANT DMD

Original Issue Date

09/27/1994

Effective Date

09/03/2024

Expiration Date

09/30/2027

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/03/2024