ROSS T BOWEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

First Name

ROSS

Middle

Last Name

BOWEN

Business Name

ROSS T BOWEN

Original Issue Date

06/04/2012

Effective Date

06/04/2012

Expiration Date

09/30/2015

City

OQUAWKA

State

Zip

61469

County

HENDERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016