JAVIER DAMONTE JOHNSON 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

JAVIER

Middle

DAMONTE

Last Name

JOHNSON

Suffix

DDS

Business Name

JAVIER DAMONTE JOHNSON DDS

Original Issue Date

06/10/2010

Effective Date

06/10/2010

Expiration Date

09/30/2012

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012