CODY JAMES WHITWORTH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

NOT RENEWED

Business

First Name

CODY

Middle

JAMES

Last Name

WHITWORTH

Business Name

CODY JAMES WHITWORTH

Original Issue Date

06/07/2016

Effective Date

06/07/2016

Expiration Date

09/30/2018

City

COLUMBIA

State

Zip

62236

County

MONROE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018