LISA MARIE BAINES DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

ACTIVE

Business

First Name

LISA

Middle

MARIE

Last Name

BAINES

Suffix

DMD

Business Name

LISA MARIE BAINES DMD

Original Issue Date

06/12/2007

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024