SHANDY SHEA CONDIE 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

SHANDY

Middle

SHEA

Last Name

CONDIE

Suffix

DDS

Business Name

SHANDY SHEA CONDIE DDS

Original Issue Date

09/14/2000

Effective Date

09/14/2000

Expiration Date

09/30/2004

City

DUNLAP

State

Zip

61525

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005