BRUCE W ANDERSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

First Name

BRUCE W

Last Name

ANDERSON

Suffix

DDS

Business Name

BRUCE W ANDERSON DDS

Original Issue Date

01/01/1998

Effective Date

09/23/2015

Expiration Date

09/30/2018

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018