ELAINE CARLSON DRAKE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

NOT RENEWED

Business

First Name

ELAINE CARLSON

Last Name

DRAKE

Business Name

ELAINE CARLSON DRAKE

Original Issue Date

01/01/1998

Effective Date

06/28/2018

Expiration Date

01/31/2022

City

BELVIDERE

State

Zip

61008

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022