NORMAN P MARTINEZ LOPEZ Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

ACTIVE

Business

First Name

NORMAN P

Middle

MARTINEZ

Last Name

LOPEZ

Business Name

NORMAN P MARTINEZ LOPEZ

Original Issue Date

01/01/1998

Effective Date

06/05/2024

Expiration Date

09/30/2027

City

GODFREY

State

Zip

62035

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/05/2024