BASIL W REMLEY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000247

License Status

NOT RENEWED

Business

First Name

BASIL W

Last Name

REMLEY

Business Name

BASIL W REMLEY

Original Issue Date

06/09/1990

Effective Date

06/09/1990

Expiration Date

09/30/1992

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

10/13/2005