DAVID STOKELY MADDOX II Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

STOKELY

Last Name

MADDOX

Suffix

Business Name

DAVID STOKELY MADDOX II

Original Issue Date

07/09/1990

Effective Date

07/09/1990

Expiration Date

09/30/1994

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005