THOMAS ALLEN JOHNSON 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

THOMAS

Middle

ALLEN

Last Name

JOHNSON

Business Name

THOMAS ALLEN JOHNSON

Original Issue Date

11/08/1990

Effective Date

11/08/1990

Expiration Date

09/30/2004

City

LOCKPORT

State

Zip

60441

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005