GALEN L DALE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

First Name

GALEN L

Last Name

DALE

Suffix

DDS

Business Name

GALEN L DALE DDS

Original Issue Date

01/01/1998

Effective Date

09/28/2021

Expiration Date

09/30/2024

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025