JORDAN NATHANIEL WILLIAMS 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

JORDAN

Middle

NATHANIEL

Last Name

WILLIAMS

Business Name

JORDAN NATHANIEL WILLIAMS

Original Issue Date

09/12/2012

Effective Date

09/05/2018

Expiration Date

01/31/2022

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022