MARY FLEAGLE ACKERMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

First Name

MARY FLEAGLE

Last Name

ACKERMAN

Business Name

MARY FLEAGLE ACKERMAN

Original Issue Date

08/09/1982

Effective Date

08/09/1982

Expiration Date

09/30/2002

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005