LINDSEY R DOUGLAS DMD Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

INOPERATIVE

Business

First Name

LINDSEY

Middle

Last Name

DOUGLAS

Suffix

DMD

Business Name

LINDSEY R DOUGLAS DMD

Original Issue Date

03/13/2001

Effective Date

03/13/2001

Expiration Date

09/30/2002

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005