KRISTEN N THOMPSON 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

KRISTEN

Middle

Last Name

THOMPSON

Business Name

KRISTEN N THOMPSON

Original Issue Date

06/05/2012

Effective Date

06/05/2012

Expiration Date

09/30/2015

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016