RICHARD EUGENE SAMPSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

NOT RENEWED

Business

First Name

RICHARD EUGENE

Last Name

SAMPSON

Business Name

RICHARD EUGENE SAMPSON

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

10/13/2005