JOHN P TANNER DDS MD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

Last Name

TANNER

Suffix

DDS MD

Business Name

JOHN P TANNER DDS MD

Original Issue Date

02/06/1990

Effective Date

02/06/1990

Expiration Date

09/30/2000

City

DANVILLE

State

Zip

61834

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005