GREGORY S LORD DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

CANCELLED

Business

First Name

GREGORY

Middle

Last Name

LORD

Suffix

DMD

Business Name

GREGORY S LORD DMD

Original Issue Date

09/29/2005

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2024