MIKAYLIN WOODSIDE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

ACTIVE

Business

Title

DMD

First Name

MIKAYLIN

Last Name

WOODSIDE

Business Name

MIKAYLIN WOODSIDE DMD

Original Issue Date

07/11/2025

Effective Date

07/11/2025

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2025