JUSTIN D ATKINSON 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

JUSTIN

Middle

Last Name

ATKINSON

Suffix

DMD

Business Name

JUSTIN D ATKINSON DMD

Original Issue Date

06/18/2007

Effective Date

08/29/2012

Expiration Date

09/30/2015

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016