DIANNE LOCKWOOD SMART ANDERSEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

NOT RENEWED

Business

First Name

DIANNE

Middle

LOCKWOOD

Last Name

SMART ANDERSEN

Suffix

DDS

Business Name

DIANNE LOCKWOOD SMART ANDERSEN DDS

Original Issue Date

11/08/2000

Effective Date

11/08/2000

Expiration Date

09/30/2002

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005