DALE ALAN JOHNSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

NOT RENEWED

Business

First Name

DALE ALAN

Last Name

JOHNSON

Suffix

DDS

Business Name

DALE ALAN JOHNSON DDS

Original Issue Date

11/29/2010

Effective Date

09/11/2015

Expiration Date

09/30/2018

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018