TODD ALLEN JOHNSON 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

TODD

Middle

ALLEN

Last Name

JOHNSON

Business Name

TODD ALLEN JOHNSON

Original Issue Date

11/25/2008

Effective Date

08/13/2015

Expiration Date

09/30/2018

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018