TODD DAVID MILLER DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

ACTIVE

Business

First Name

TODD

Middle

DAVID

Last Name

MILLER

Suffix

DMD

Business Name

TODD DAVID MILLER DMD

Original Issue Date

02/13/2001

Effective Date

09/10/2024

Expiration Date

09/30/2027

City

MANTENO

State

Zip

60950

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/10/2024