IAN FOSTER MONTIE 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

Title

DDS

First Name

IAN

Middle

FOSTER

Last Name

MONTIE

Business Name

IAN FOSTER MONTIE DDS

Original Issue Date

07/20/2015

Effective Date

07/20/2015

Expiration Date

09/30/2018

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018