REBECCA J FORNERO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

REBECCA J

Last Name

FORNERO

Business Name

REBECCA J FORNERO

Original Issue Date

09/11/1989

Effective Date

09/11/1989

Expiration Date

09/30/1996

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005