RICHARD A MARTIN DDS Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

INOPERATIVE

Business

First Name

RICHARD A

Last Name

MARTIN

Suffix

DDS

Business Name

RICHARD A MARTIN DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2000

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005