DANIEL S CANNON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

NOT RENEWED

Business

Title

DDS

First Name

DANIEL

Middle

Last Name

CANNON

Business Name

DANIEL S CANNON DDS

Original Issue Date

01/27/2010

Effective Date

01/27/2010

Expiration Date

09/30/2012

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012