TERRY JON ORTMAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

Title

DDS

First Name

TERRY

Middle

JON

Last Name

ORTMAN

Business Name

TERRY JON ORTMAN DDS

Original Issue Date

01/01/1998

Effective Date

11/20/2015

Expiration Date

09/30/2018

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018