LAWRENCE ELLIOTT LISTON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000839

License Status

ACTIVE

Business

First Name

LAWRENCE

Middle

ELLIOTT

Last Name

LISTON

Suffix

DDS

Business Name

LAWRENCE ELLIOTT LISTON DDS

Original Issue Date

05/09/2012

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

GALESBURG

State

Zip

61401

County

MCLEAN

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

10/28/2024