MARY THERESE MADIGAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****92

License Status

NOT RENEWED

Business

First Name

MARY THERESE

Last Name

MADIGAN

Business Name

MARY THERESE MADIGAN

Original Issue Date

12/20/1983

Effective Date

12/20/1983

Expiration Date

09/30/1984

City

KEWANEE

State

Zip

61443

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005