JOHN D MILLER DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

CANCELLED

Business

First Name

JOHN

Middle

Last Name

MILLER

Suffix

DMD

Business Name

JOHN D MILLER DMD

Original Issue Date

07/22/2004

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2009