ALAN HUBER BROADBENT DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

First Name

ALAN HUBER

Last Name

BROADBENT

Suffix

DMD

Business Name

ALAN HUBER BROADBENT DMD

Original Issue Date

01/01/1998

Effective Date

03/13/2013

Expiration Date

09/30/2015

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016