DAVID E CRADDOCK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****98

License Status

NOT RENEWED

Business

First Name

DAVID E

Last Name

CRADDOCK

Business Name

DAVID E CRADDOCK

Original Issue Date

12/01/1989

Effective Date

12/01/1989

Expiration Date

09/30/2002

City

KEWANEE

State

Zip

61443

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005