MICHAEL B WILLENBORG DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

CANCELLED

Business

First Name

MICHAEL B

Last Name

WILLENBORG

Suffix

DDS

Business Name

MICHAEL B WILLENBORG DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2006

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

07/24/2006