KORT PAUL HERMAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

NOT RENEWED

Business

Title

DMD

First Name

KORT

Middle

PAUL

Last Name

HERMAN

Business Name

KORT PAUL HERMAN DMD

Original Issue Date

06/11/2008

Effective Date

09/03/2015

Expiration Date

09/30/2018

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018