MIKE R MCCLURE 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

MIKE

Middle

Last Name

MCCLURE

Business Name

MIKE R MCCLURE

Original Issue Date

08/29/2002

Effective Date

09/15/2009

Expiration Date

09/30/2012

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012