CLIFFORD GRANT NEILL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

First Name

CLIFFORD GRANT

Last Name

NEILL

Business Name

CLIFFORD GRANT NEILL

Original Issue Date

01/01/1998

Effective Date

08/27/2009

Expiration Date

09/30/2012

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012