WAYNE FRANCIS SKALOUD 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

WAYNE FRANCIS

Last Name

SKALOUD

Suffix

DDS

Business Name

WAYNE FRANCIS SKALOUD DDS

Original Issue Date

01/01/1998

Effective Date

06/09/2009

Expiration Date

09/30/2012

City

GALVA

State

Zip

61434

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012