ELIZABETH ASHLEE KLANDERMAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

NOT RENEWED

Business

Title

DMD

First Name

ELIZABETH

Middle

ASHLEE

Last Name

KLANDERMAN

Business Name

ELIZABETH ASHLEE KLANDERMAN DMD

Original Issue Date

07/20/2012

Effective Date

07/20/2012

Expiration Date

09/30/2015

City

JACKSONVILLE

State

Zip

32210

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016