JOHN WALTER PACEY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****19

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

WALTER

Last Name

PACEY

Business Name

JOHN WALTER PACEY

Original Issue Date

01/01/1998

Expiration Date

09/30/2006

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006