JOHN MARCELLUS BEATTY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000236

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

MARCELLUS

Last Name

BEATTY

Suffix

DDS

Business Name

JOHN MARCELLUS BEATTY DDS

Original Issue Date

02/15/1990

Effective Date

10/01/2009

Expiration Date

09/30/2012

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/14/2012