JORDAN ERIC SPENCER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****60

License Status

NOT RENEWED

Business

First Name

JORDAN

Middle

ERIC

Last Name

SPENCER

Suffix

DDS

Business Name

JORDAN ERIC SPENCER DDS

Original Issue Date

12/22/2011

Effective Date

08/28/2012

Expiration Date

09/30/2015

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016