PHILIP R BAYNE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

NOT RENEWED

Business

First Name

PHILIP R

Last Name

BAYNE

Suffix

DDS

Business Name

PHILIP R BAYNE DDS

Original Issue Date

01/29/1992

Effective Date

01/29/1992

Expiration Date

09/30/2002

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005