PETER ELLIS GLATZ DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

NOT RENEWED

Business

First Name

PETER ELLIS

Last Name

GLATZ

Suffix

DDS

Business Name

PETER ELLIS GLATZ DDS

Original Issue Date

01/01/1998

Effective Date

08/11/2015

Expiration Date

09/30/2018

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018