DANIEL B SULLIVAN JR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****30

License Status

NOT RENEWED

Business

First Name

DANIEL B

Last Name

SULLIVAN JR

Suffix

DDS

Business Name

DANIEL B SULLIVAN JR DDS

Original Issue Date

04/17/1990

Effective Date

04/17/1990

Expiration Date

09/30/2000

City

BARTONVILLE

State

Zip

61607

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005