ELLEN A SHERIDAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

First Name

ELLEN A

Last Name

SHERIDAN

Business Name

ELLEN A SHERIDAN

Original Issue Date

12/08/1986

Effective Date

12/08/1986

Expiration Date

09/30/1988

City

VIENNA

State

Zip

62995

County

JOHNSON

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/13/2005