GREGORY J POWELL DDS 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

GREGORY J

Last Name

POWELL

Suffix

DDS

Business Name

GREGORY J POWELL DDS

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005