JONATHAN LOUIS GIFFORD DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

ACTIVE

Business

Title

DDS

First Name

JONATHAN

Middle

LOUIS

Last Name

GIFFORD

Business Name

JONATHAN LOUIS GIFFORD DDS

Original Issue Date

08/16/2016

Effective Date

08/13/2024

Expiration Date

09/30/2027

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024