KENNETH DALE REPINE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010226

License Status

NOT RENEWED

Business

First Name

KENNETH DALE

Last Name

REPINE

Suffix

DDS

Business Name

KENNETH DALE REPINE DDS

Original Issue Date

12/05/1952

Effective Date

12/05/1952

Expiration Date

09/30/1984

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Ever Disciplined

LastModifiedDate

10/12/2005