MADALYN MOTZ DAVIDSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

First Name

MADALYN

Middle

MOTZ

Last Name

DAVIDSON

Business Name

MADALYN MOTZ DAVIDSON

Original Issue Date

06/11/2007

Effective Date

09/21/2015

Expiration Date

09/30/2018

City

TUSCOLA

State

Zip

61953

County

DOUGLAS

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/31/2018