NICCOLE R BROWNFIELD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

NOT RENEWED

Business

First Name

NICCOLE

Middle

Last Name

BROWNFIELD

Suffix

DDS

Business Name

NICCOLE R BROWNFIELD DDS

Original Issue Date

09/16/1998

Effective Date

09/16/1998

Expiration Date

09/30/2000

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005