CYNTHIA D MILLER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

NOT RENEWED

Business

First Name

CYNTHIA

Middle

Last Name

MILLER

Suffix

DMD

Business Name

CYNTHIA D MILLER DMD

Original Issue Date

10/18/2000

Effective Date

08/09/2012

Expiration Date

09/30/2015

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016