EDMUND MARTIN COLLINS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

EDMUND MARTIN

Last Name

COLLINS

Business Name

EDMUND MARTIN COLLINS

Original Issue Date

01/01/1998

Expiration Date

01/01/1998

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005