CHARLES WILLIAM MYRNA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

CHARLES WILLIAM

Last Name

MYRNA

Suffix

DDS

Business Name

CHARLES WILLIAM MYRNA DDS

Original Issue Date

01/01/1998

Effective Date

06/15/2009

Expiration Date

09/30/2012

City

CARMI

State

Zip

62821

County

WHITE

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

11/14/2012