BRIAN M JOHNSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

JOHNSON

Suffix

DDS

Business Name

BRIAN M JOHNSON DDS

Original Issue Date

03/08/2012

Effective Date

09/06/2012

Expiration Date

09/30/2015

City

OREGON

State

Zip

61061

County

OGLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016