JACK G WALZ DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****07

License Status

ACTIVE

Business

First Name

JACK G

Last Name

WALZ

Suffix

DDS

Business Name

JACK G WALZ DDS

Original Issue Date

01/31/1991

Effective Date

08/20/2024

Expiration Date

09/30/2027

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/20/2024