GERALD W STONECIPHER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****61

License Status

NOT RENEWED

Business

First Name

GERALD W

Last Name

STONECIPHER

Suffix

DDS

Business Name

GERALD W STONECIPHER DDS

Original Issue Date

01/01/1998

Effective Date

08/17/2012

Expiration Date

09/30/2015

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016