LYNN M BRENEMAN WISONG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

First Name

LYNN

Middle

Last Name

BRENEMAN WISONG

Business Name

LYNN M BRENEMAN WISONG

Original Issue Date

10/21/2008

Effective Date

07/10/2012

Expiration Date

09/30/2015

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016