MIRANDA LOUISE FOSTER 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

Title

DDS

First Name

MIRANDA

Middle

LOUISE

Last Name

FOSTER

Business Name

MIRANDA LOUISE FOSTER DDS

Original Issue Date

08/07/2017

Effective Date

08/20/2018

Expiration Date

01/31/2022

City

PROPHETSTOWN

State

Zip

61277

County

OGLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/09/2022