RYAN TAYLOR BLATCHLEY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

Title

DDS

First Name

RYAN

Middle

TAYLOR

Last Name

BLATCHLEY

Business Name

RYAN TAYLOR BLATCHLEY DDS

Original Issue Date

05/25/2017

Effective Date

05/25/2017

Expiration Date

09/30/2018

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018