KRISTOFFER JAN TUMILOWICZ DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000399

License Status

NOT RENEWED

Business

First Name

KRISTOFFER

Middle

JAN

Last Name

TUMILOWICZ

Suffix

DMD

Business Name

KRISTOFFER JAN TUMILOWICZ DMD

Original Issue Date

06/25/1996

Effective Date

11/04/2021

Expiration Date

09/30/2024

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

02/04/2025