ALAN HUBER BROADBENT DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015104

License Status

NOT RENEWED

Business

First Name

ALAN HUBER

Last Name

BROADBENT

Suffix

DMD

Business Name

ALAN HUBER BROADBENT DMD

Original Issue Date

07/10/1975

Effective Date

07/16/2012

Expiration Date

09/30/2015

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

02/08/2016