THOMAS W FONNER DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

ACTIVE

Business

First Name

THOMAS

Middle

Last Name

FONNER

Suffix

DMD

Business Name

THOMAS W FONNER DMD

Original Issue Date

02/11/1999

Effective Date

06/03/2024

Expiration Date

09/30/2027

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2024