MICHAEL P TRAVIS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

TRAVIS

Business Name

MICHAEL P TRAVIS

Original Issue Date

04/21/2017

Effective Date

04/21/2017

Expiration Date

09/30/2018

City

UNIVERSITY CITY

State

Zip

63130

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018