TIMOTHY JAMES SMITH 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

TIMOTHY

Middle

JAMES

Last Name

SMITH

Business Name

TIMOTHY JAMES SMITH

Original Issue Date

05/03/2011

Effective Date

08/06/2018

Expiration Date

01/31/2022

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022