RICHARD GREY LORD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

NOT RENEWED

Business

Title

DDS

First Name

RICHARD

Middle

GREY

Last Name

LORD

Business Name

RICHARD GREY LORD DDS

Original Issue Date

01/17/1986

Effective Date

01/17/1986

Expiration Date

09/30/1992

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005