GREG B GODFREY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

NOT RENEWED

Business

First Name

GREG

Middle

Last Name

GODFREY

Suffix

DDS

Business Name

GREG B GODFREY DDS

Original Issue Date

06/25/2010

Effective Date

06/25/2010

Expiration Date

09/30/2012

City

OQUAWKA

State

Zip

61469

County

HENDERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012