DOUGLAS ALAN DRAKE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

First Name

DOUGLAS ALAN

Last Name

DRAKE

Business Name

DOUGLAS ALAN DRAKE

Original Issue Date

01/01/1998

Expiration Date

09/30/1994

City

BELVIDERE

State

Zip

61008

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005