JON RICHARD CONKLIN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

NOT RENEWED

Business

First Name

JON RICHARD

Last Name

CONKLIN

Suffix

DDS

Business Name

JON RICHARD CONKLIN DDS

Original Issue Date

01/01/1998

Effective Date

08/25/2009

Expiration Date

09/30/2012

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012