LAURA ASHLEY HIBBARD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****27

License Status

INACTIVE

Business

First Name

LAURA

Middle

ASHLEY

Last Name

HIBBARD

Business Name

LAURA ASHLEY HIBBARD

Original Issue Date

09/04/2018

Effective Date

09/04/2018

Expiration Date

12/31/2021

City

ORANGEVILLE

State

Zip

61060

County

STEPHENSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2021