WILLIAM HARRISON PUTMAN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

ACTIVE

Business

First Name

WILLIAM

Middle

HARRISON

Last Name

PUTMAN

Business Name

WILLIAM HARRISON PUTMAN

Original Issue Date

10/15/2018

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024