JOHN W PRUITT 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

JOHN W

Last Name

PRUITT

Suffix

DDS

Business Name

JOHN W PRUITT DDS

Original Issue Date

01/23/1990

Effective Date

01/23/1990

Expiration Date

09/30/1994

City

URBANA

State

Zip

61821

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005