CARL FRED HAISER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

NOT RENEWED

Business

First Name

CARL FRED

Last Name

HAISER

Business Name

CARL FRED HAISER

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

CAHOKIA

State

Zip

62206

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005