ZACHARY TYLER FERGUSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

ACTIVE

Business

First Name

ZACHARY

Middle

TYLER

Last Name

FERGUSON

Business Name

ZACHARY TYLER FERGUSON

Original Issue Date

07/30/2019

Effective Date

09/09/2024

Expiration Date

09/30/2027

City

PARIS

State

Zip

61944

County

EDGAR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/09/2024