ROBERT M MIKLESH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****30

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

Last Name

MIKLESH

Business Name

ROBERT M MIKLESH

Original Issue Date

11/27/2007

Effective Date

11/27/2007

Expiration Date

09/30/2009

City

ROCHELLE

State

Zip

61068

County

OGLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009