JOHN ALAN WILDE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

ALAN

Last Name

WILDE

Suffix

DDS

Business Name

JOHN ALAN WILDE DDS

Original Issue Date

07/06/2010

Effective Date

06/06/2012

Expiration Date

09/30/2015

City

KEOKUK

State

Zip

52632

County

IOWA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016