TREVOR DANIEL RICHMOND DMD 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

DMD

First Name

TREVOR

Middle

DANIEL

Last Name

RICHMOND

Business Name

TREVOR DANIEL RICHMOND DMD

Original Issue Date

06/17/2020

Effective Date

10/09/2021

Expiration Date

09/30/2024

City

MAPLETON

State

Zip

61547

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

02/04/2025