JACQUELYN L RICHARDSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****42

License Status

NOT RENEWED

Business

First Name

JACQUELYN

Middle

Last Name

RICHARDSON

Suffix

DDS

Business Name

JACQUELYN L RICHARDSON DDS

Original Issue Date

10/13/2004

Effective Date

09/22/2021

Expiration Date

09/30/2024

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025