MATTHEW WILLIAM MCMILLAN Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001626

License Status

EXPIRED

Business

First Name

MATTHEW

Middle

WILLIAM

Last Name

MCMILLAN

Business Name

MATTHEW WILLIAM MCMILLAN

Original Issue Date

05/21/2007

Effective Date

05/21/2007

Expiration Date

06/30/2009

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

07/15/2009