VAN NGUYEN SPROUL DDS 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

VAN

Middle

NGUYEN

Last Name

SPROUL

Suffix

DDS

Business Name

VAN NGUYEN SPROUL DDS

Original Issue Date

10/04/1999

Effective Date

10/04/1999

Expiration Date

09/30/2002

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005