SCOTT W ANDERSON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

ACTIVE

Business

First Name

SCOTT W

Last Name

ANDERSON

Suffix

DDS

Business Name

SCOTT W ANDERSON DDS

Original Issue Date

09/09/1996

Effective Date

06/14/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2024