ERIK HARRIS JOHNSON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

NOT RENEWED

Business

Title

DMD

First Name

ERIK

Middle

HARRIS

Last Name

JOHNSON

Business Name

ERIK HARRIS JOHNSON DMD

Original Issue Date

06/19/2009

Effective Date

06/19/2009

Expiration Date

09/30/2012

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012