KELLY ANNE PLOTE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

ANNE

Last Name

PLOTE

Suffix

DDS

Business Name

KELLY ANNE PLOTE DDS

Original Issue Date

05/15/2012

Effective Date

08/29/2012

Expiration Date

09/30/2015

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016