BRUCE E MATHES Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

First Name

BRUCE E

Last Name

MATHES

Business Name

BRUCE E MATHES

Original Issue Date

09/30/1991

Effective Date

09/30/1991

Expiration Date

09/30/1992

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005