WAYNE RICHARD JOHNSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011894

License Status

NOT RENEWED

Business

First Name

WAYNE RICHARD

Last Name

JOHNSON

Suffix

DDS

Business Name

WAYNE RICHARD JOHNSON DDS

Original Issue Date

07/31/1961

Effective Date

07/31/1961

Expiration Date

09/30/1986

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/12/2005