LLOYD GEORGE FORESTER JR 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

LLOYD

Middle

GEORGE

Last Name

FORESTER

Suffix

Business Name

LLOYD GEORGE FORESTER JR

Original Issue Date

10/30/2001

Effective Date

10/30/2001

Expiration Date

09/30/2006

City

DUPO

State

Zip

62239

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006