JON K DIVELY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013962

License Status

NOT RENEWED

Business

First Name

JON

Middle

Last Name

DIVELY

Suffix

DDS

Business Name

JON K DIVELY DDS

Original Issue Date

01/27/1970

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

05/09/2022

Case Number

2005002872

Action

Fine

Discipline Start Date

06/06/2007

Discipline Reason

for improper medication prescribing practice.