PATRICK DAVID MILLER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

NOT RENEWED

Business

First Name

PATRICK

Middle

DAVID

Last Name

MILLER

Suffix

DMD

Business Name

PATRICK DAVID MILLER DMD

Original Issue Date

08/03/2001

Effective Date

09/05/2018

Expiration Date

01/31/2022

City

CHESTER

State

Zip

62233

County

RANDOLPH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022