DOUGLAS T ANDERSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****14

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

Last Name

ANDERSON

Suffix

DDS

Business Name

DOUGLAS T ANDERSON DDS

Original Issue Date

02/09/1984

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022