JOHN WILLIAM MACDONALD DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

CANCELLED

Business

First Name

JOHN

Middle

WILLIAM

Last Name

MACDONALD

Suffix

DDS

Business Name

JOHN WILLIAM MACDONALD DDS

Original Issue Date

07/17/2000

Effective Date

07/17/2000

Expiration Date

09/30/2002

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005