SCOTT WAYNE POWERS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000056

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

WAYNE

Last Name

POWERS

Suffix

DDS

Business Name

SCOTT WAYNE POWERS DDS

Original Issue Date

05/05/1999

Effective Date

05/05/1999

Expiration Date

07/01/2000

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

10/13/2005