DWIGHT RICHARD DAUGHERTY DDS 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

DWIGHT RICHARD

Last Name

DAUGHERTY

Suffix

DDS

Business Name

DWIGHT RICHARD DAUGHERTY DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1984

City

ROCK FALLS

State

Zip

61071

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005