KEVIN THOMAS WOLF Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

ACTIVE

Business

First Name

KEVIN

Middle

THOMAS

Last Name

WOLF

Business Name

KEVIN THOMAS WOLF

Original Issue Date

08/21/2018

Effective Date

05/04/2024

Expiration Date

09/30/2027

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2024