DANIEL WILLIAM JOHNSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

ACTIVE

Business

First Name

DANIEL WILLIAM

Last Name

JOHNSON

Business Name

DANIEL WILLIAM JOHNSON

Original Issue Date

02/25/1985

Effective Date

05/06/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2024