EARL EDWIN MARTIN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

EARL

Middle

EDWIN

Last Name

MARTIN

Suffix

DDS

Business Name

EARL EDWIN MARTIN DDS

Original Issue Date

01/01/1998

Effective Date

10/01/2018

Expiration Date

01/31/2022

City

COAL VALLEY

State

Zip

61240

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022