WILLIAM W WELLER 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

WILLIAM W

Last Name

WELLER

Business Name

WILLIAM W WELLER

Original Issue Date

06/25/2012

Effective Date

06/25/2012

Expiration Date

09/30/2015

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016