STANLEY L LIBRACH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

First Name

STANLEY L

Last Name

LIBRACH

Business Name

STANLEY L LIBRACH

Original Issue Date

03/17/1994

Effective Date

03/17/1994

Expiration Date

09/30/1998

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005