JUSTIN AULT DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****27

License Status

ACTIVE

Business

Title

DMD

First Name

JUSTIN

Last Name

AULT

Business Name

JUSTIN AULT DMD

Original Issue Date

06/30/2021

Effective Date

07/10/2024

Expiration Date

09/30/2027

City

TOLONO

State

Zip

61880

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

07/10/2024