GARY W MILLER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

NOT RENEWED

Business

First Name

GARY W

Last Name

MILLER

Business Name

GARY W MILLER

Original Issue Date

07/22/1987

Effective Date

08/24/2009

Expiration Date

09/30/2012

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/14/2012