MILTON L DAVENPORT III DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

Title

DMD

First Name

MILTON

Middle

Last Name

DAVENPORT

Suffix

III

Business Name

MILTON L DAVENPORT III DMD

Original Issue Date

07/13/2009

Effective Date

07/13/2009

Expiration Date

09/30/2012

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/14/2012