ABIGAIL SUSAN WIDMAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****14

License Status

NOT RENEWED

Business

Title

DDS

First Name

ABIGAIL

Middle

SUSAN

Last Name

WIDMAN

Business Name

ABIGAIL SUSAN WIDMAN DDS

Original Issue Date

07/24/2023

Effective Date

07/24/2023

Expiration Date

09/30/2024

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025