EDWILL ORBERT MASSEY 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

EDWILL ORBERT

Last Name

MASSEY

Business Name

EDWILL ORBERT MASSEY

Original Issue Date

03/18/1986

Effective Date

03/18/1986

Expiration Date

09/30/1988

City

EAST ST LOUIS

State

Zip

62205

County

SAINT CLAIR

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/13/2005