LORA B WILSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

LORA B

Last Name

WILSON

Business Name

LORA B WILSON

Original Issue Date

04/03/1996

Effective Date

04/03/1996

Expiration Date

09/30/1998

City

STERLING

State

Zip

61081

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005