WALTER DONALD MADDOX Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

INOPERATIVE

Business

First Name

WALTER DONALD

Last Name

MADDOX

Business Name

WALTER DONALD MADDOX

Original Issue Date

01/01/1998

Expiration Date

09/30/1998

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005