RONALD ROY JOHNSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012371

License Status

NOT RENEWED

Business

First Name

RONALD ROY

Last Name

JOHNSON

Suffix

DDS

Business Name

RONALD ROY JOHNSON DDS

Original Issue Date

12/03/1963

Effective Date

12/03/1963

Expiration Date

09/30/2004

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/17/2005