ANITA T DRAKE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

NOT RENEWED

Business

First Name

ANITA T

Last Name

DRAKE

Suffix

DDS

Business Name

ANITA T DRAKE DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1990

City

RIVERTON

State

Zip

62561

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005