RALPH THEODORE NELSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

NOT RENEWED

Business

First Name

RALPH THEODORE

Last Name

NELSON

Suffix

DDS

Business Name

RALPH THEODORE NELSON DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2000

City

PEORIA

State

Zip

61604

County

PEORIA

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/17/2005