MICHAEL KENT FULTON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

KENT

Last Name

FULTON

Business Name

MICHAEL KENT FULTON

Original Issue Date

01/01/1998

Effective Date

09/25/2015

Expiration Date

09/30/2018

City

VANDALIA

State

Zip

62471

County

FAYETTE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018