KEITH ALLEN EVANS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

ACTIVE

Business

First Name

KEITH

Middle

ALLEN

Last Name

EVANS

Suffix

DMD

Business Name

KEITH ALLEN EVANS DMD

Original Issue Date

07/16/2002

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024