STACEY K VAN SCOYOC Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****65

License Status

ACTIVE

Business

First Name

STACEY K

Last Name

VAN SCOYOC

Business Name

STACEY K VAN SCOYOC

Original Issue Date

12/14/1995

Effective Date

06/14/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2024