BENJAMIN SCOTT JOHNSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

Title

DDS

First Name

BENJAMIN

Middle

SCOTT

Last Name

JOHNSON

Business Name

BENJAMIN SCOTT JOHNSON DDS

Original Issue Date

02/02/2017

Effective Date

02/02/2017

Expiration Date

09/30/2018

City

DELAVAN

State

Zip

53115

County

WISCONSIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018