RAYMOND GERARD NIKODEM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

NOT RENEWED

Business

Title

DDS

First Name

RAYMOND

Middle

GERARD

Last Name

NIKODEM

Business Name

RAYMOND GERARD NIKODEM DDS

Original Issue Date

09/27/2012

Effective Date

09/27/2012

Expiration Date

09/30/2015

City

CHESTERFIELD

State

Zip

63005

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016