SEAN WILLIAM ERICSON 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

Title

DDS

First Name

SEAN

Middle

WILLIAM

Last Name

ERICSON

Business Name

SEAN WILLIAM ERICSON DDS

Original Issue Date

10/15/2013

Effective Date

12/10/2015

Expiration Date

09/30/2018

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018