RANDALL C REYES Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

INOPERATIVE

Business

First Name

RANDALL C

Last Name

REYES

Business Name

RANDALL C REYES

Original Issue Date

04/08/1993

Effective Date

04/08/1993

Expiration Date

09/30/1998

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005