SUSAN WELLER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

SUSAN

Last Name

WELLER

Business Name

SUSAN WELLER

Original Issue Date

06/21/1982

Effective Date

06/19/2018

Expiration Date

01/31/2022

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022