BRANDON ROBERT MADDOX Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

ACTIVE

Business

First Name

BRANDON

Middle

ROBERT

Last Name

MADDOX

Business Name

BRANDON ROBERT MADDOX

Original Issue Date

08/10/2001

Effective Date

05/06/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2024