WALTER ANTHONY MAUCK JR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

NOT RENEWED

Business

First Name

WALTER ANTHONY

Last Name

MAUCK JR

Suffix

DDS

Business Name

WALTER ANTHONY MAUCK JR DDS

Original Issue Date

09/14/1981

Effective Date

09/14/1981

Expiration Date

09/30/1996

City

MCLEANSBORO

State

Zip

62859

County

HAMILTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005