AMANDA N STEWART Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

STEWART

Business Name

AMANDA N STEWART

Original Issue Date

06/27/2006

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009