M CAMILLE FULLER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019021970

License Status

NOT RENEWED

Business

First Name

Middle

CAMILLE

Last Name

FULLER

Suffix

DDS

Business Name

M CAMILLE FULLER DDS

Original Issue Date

03/09/1990

Effective Date

09/22/2009

Expiration Date

09/30/2012

City

SAINT LOUIS

State

Zip

63132

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/14/2012