BENJAMIN ROSS SELDEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****40

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

ROSS

Last Name

SELDEN

Suffix

DDS

Business Name

BENJAMIN ROSS SELDEN DDS

Original Issue Date

05/05/2011

Effective Date

11/12/2015

Expiration Date

09/30/2018

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018