Dentist
LICENSED DENTIST CONTROLLED SUBSTANCE
31*****06
NOT RENEWED
N
DDS
MEGHAN
WAGSTAFF
LAYNE
MEGHAN WAGSTAFF LAYNE DDS
01/09/2015
09/29/2015
09/30/2018
ALTON
IL
62002
MADISON
PRACTITIONER
II III IV V
10/31/2018