PARKER JOSEPH OLIVER ROUSTIO Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

ACTIVE

Business

First Name

PARKER

Middle

JOSEPH OLIVER

Last Name

ROUSTIO

Business Name

PARKER JOSEPH OLIVER ROUSTIO

Original Issue Date

01/05/2024

Effective Date

05/08/2024

Expiration Date

09/30/2027

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/08/2024