DUANE ARDIE DILWORTH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

DUANE ARDIE

Last Name

DILWORTH

Business Name

DUANE ARDIE DILWORTH

Original Issue Date

08/30/1985

Effective Date

08/30/1985

Expiration Date

09/30/1988

City

FAIRVIEW HEIGHTS

State

Zip

62203

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005