JOHN LOUIS WIETHOLDER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

NOT RENEWED

Business

Title

DMD

First Name

JOHN

Middle

LOUIS

Last Name

WIETHOLDER

Business Name

JOHN LOUIS WIETHOLDER DMD

Original Issue Date

06/07/2011

Effective Date

06/08/2015

Expiration Date

09/30/2018

City

CLARKSVILLE

State

Zip

37042

County

TENNESSEE

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/31/2018