CHARLES MARCUS ZIEBA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

MARCUS

Last Name

ZIEBA

Suffix

DMD

Business Name

CHARLES MARCUS ZIEBA DMD

Original Issue Date

02/01/2001

Effective Date

02/01/2001

Expiration Date

09/30/2006

City

EAST ALTON

State

Zip

62024

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006