RYAN DANIEL JOHNSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

ACTIVE

Business

First Name

RYAN

Middle

DANIEL

Last Name

JOHNSON

Business Name

RYAN DANIEL JOHNSON

Original Issue Date

07/23/2009

Effective Date

09/18/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/18/2024