JOHN W PRUITT DDS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027829

License Status

EXPIRED

Business

First Name

JOHN W

Last Name

PRUITT

Suffix

DDS

Business Name

JOHN W PRUITT DDS

Original Issue Date

05/04/1992

Effective Date

05/04/1992

Expiration Date

06/30/1995

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006