DONALD THEODORE MILLER JR DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

NOT RENEWED

Business

First Name

DONALD THEODORE

Last Name

MILLER JR

Suffix

DMD

Business Name

DONALD THEODORE MILLER JR DMD

Original Issue Date

08/24/1981

Effective Date

09/11/2012

Expiration Date

09/30/2015

City

GENOA

State

Zip

60135

County

DEKALB

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016