MEGAN MARIE DANIELS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

NOT RENEWED

Business

Title

DDS

First Name

MEGAN

Middle

MARIE

Last Name

DANIELS

Business Name

MEGAN MARIE DANIELS DDS

Original Issue Date

06/24/2016

Effective Date

06/24/2016

Expiration Date

09/30/2018

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018