HARRELL C WATTS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

ACTIVE

Business

First Name

HARRELL

Middle

Last Name

WATTS

Business Name

HARRELL C WATTS

Original Issue Date

07/18/2006

Effective Date

05/07/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/07/2024