JEFFREY M WALTON 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

JEFFREY

Middle

Last Name

WALTON

Business Name

JEFFREY M WALTON

Original Issue Date

07/23/2002

Effective Date

07/23/2002

Expiration Date

09/30/2006

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006