MELVIN HUGH MARTIN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

Title

DMD

First Name

MELVIN

Middle

HUGH

Last Name

MARTIN

Business Name

MELVIN HUGH MARTIN DMD

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

PITTSFIELD

State

Zip

62363

County

PIKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009