GAYLEN LEE JOHNSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024780

License Status

NOT RENEWED

Business

First Name

GAYLEN

Middle

LEE

Last Name

JOHNSON

Suffix

DDS

Business Name

GAYLEN LEE JOHNSON DDS

Original Issue Date

07/24/1998

Effective Date

07/24/2015

Expiration Date

09/30/2018

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

10/31/2018