ANTHONY JOHN TEGENKAMP DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****20

License Status

NOT RENEWED

Business

First Name

ANTHONY JOHN

Last Name

TEGENKAMP

Suffix

DMD

Business Name

ANTHONY JOHN TEGENKAMP DMD

Original Issue Date

10/01/1996

Effective Date

10/01/1996

Expiration Date

09/30/2000

City

ALTAMONT

State

Zip

62411

County

EFFINGHAM

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005