TERENCE J WHITAKER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

NOT RENEWED

Business

First Name

TERENCE

Middle

Last Name

WHITAKER

Business Name

TERENCE J WHITAKER

Original Issue Date

07/24/2009

Effective Date

07/24/2009

Expiration Date

09/30/2012

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/14/2012