LARRY DON PAGE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

NOT RENEWED

Business

First Name

LARRY DON

Last Name

PAGE

Business Name

LARRY DON PAGE

Original Issue Date

04/04/1983

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

MOWEAQUA

State

Zip

62550

County

SHELBY

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

05/09/2022