ROBERT STEWART NOVOTNY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

STEWART

Last Name

NOVOTNY

Suffix

DDS

Business Name

ROBERT STEWART NOVOTNY DDS

Original Issue Date

01/01/1998

Effective Date

07/06/2010

Expiration Date

09/30/2012

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012