DOUGLAS R DIXON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

Last Name

DIXON

Suffix

DMD

Business Name

DOUGLAS R DIXON DMD

Original Issue Date

03/20/2007

Effective Date

03/20/2007

Expiration Date

09/30/2009

City

GREAT LAKES

State

Zip

60088

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009