DERYL W DRUM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

NOT RENEWED

Business

First Name

DERYL W

Last Name

DRUM

Business Name

DERYL W DRUM

Original Issue Date

11/18/1991

Effective Date

08/05/2015

Expiration Date

09/30/2018

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018