MICHAEL R WATTLES Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

ACTIVE

Business

First Name

MICHAEL R

Last Name

WATTLES

Business Name

MICHAEL R WATTLES

Original Issue Date

08/24/1988

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

ROCHELLE

State

Zip

61068

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024