JUANITA R TAYLOR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****66

License Status

NOT RENEWED

Business

First Name

JUANITA R

Last Name

TAYLOR

Business Name

JUANITA R TAYLOR

Original Issue Date

09/21/2007

Effective Date

12/09/2021

Expiration Date

09/30/2024

City

INDIANAPOLIS

State

Zip

46278

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025