STEVEN ANDREW NELSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

First Name

STEVEN

Middle

ANDREW

Last Name

NELSON

Suffix

DDS

Business Name

STEVEN ANDREW NELSON DDS

Original Issue Date

06/01/2011

Effective Date

10/02/2012

Expiration Date

09/30/2015

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016