PATRICK B SHAFFER DDS Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

INOPERATIVE

Business

First Name

PATRICK B

Last Name

SHAFFER

Suffix

DDS

Business Name

PATRICK B SHAFFER DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005