MILEN VITANOV VITANOV DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019031422

License Status

INACTIVE

Business

Title

DMD

First Name

MILEN

Middle

VITANOV

Last Name

VITANOV

Business Name

MILEN VITANOV VITANOV DMD

Original Issue Date

10/03/2017

Effective Date

06/12/2018

Expiration Date

09/30/2021

City

BLOOMINGTON

State

Zip

61704

Ever Disciplined

LastModifiedDate

06/12/2018