DANIEL JON LOBAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

JON

Last Name

LOBAN

Business Name

DANIEL JON LOBAN

Original Issue Date

08/02/2007

Effective Date

09/29/2009

Expiration Date

09/30/2012

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012