NICHOLAS DALE SWANSON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

ACTIVE

Business

Title

DMD

First Name

NICHOLAS

Middle

DALE

Last Name

SWANSON

Business Name

NICHOLAS DALE SWANSON DMD

Original Issue Date

07/11/2024

Effective Date

07/11/2024

Expiration Date

09/30/2027

City

MASCOUTAH

State

Zip

62258

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2024