JONATHAN THOMAS MISNER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

NOT RENEWED

Business

Title

DMD

First Name

JONATHAN

Middle

THOMAS

Last Name

MISNER

Business Name

JONATHAN THOMAS MISNER DMD

Original Issue Date

06/04/2013

Effective Date

09/30/2015

Expiration Date

09/30/2018

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/31/2018