JOHN MARCELLUS BEATTY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

MARCELLUS

Last Name

BEATTY

Suffix

DDS

Business Name

JOHN MARCELLUS BEATTY DDS

Original Issue Date

06/01/1976

Effective Date

05/09/2013

Expiration Date

09/30/2015

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016