NICHOLAS BRYCE KOREN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

Title

DMD

First Name

NICHOLAS

Middle

BRYCE

Last Name

KOREN

Business Name

NICHOLAS BRYCE KOREN DMD

Original Issue Date

04/20/2016

Effective Date

04/20/2016

Expiration Date

09/30/2018

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018