MICHAEL THOMAS BECKHAM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

MICHAEL THOMAS

Last Name

BECKHAM

Suffix

DDS

Business Name

MICHAEL THOMAS BECKHAM DDS

Original Issue Date

11/13/1981

Effective Date

11/13/1981

Expiration Date

06/01/1982

City

KANKAKEE

State

Zip

61443

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005