SAMIR E RUVINOV DDS 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

SAMIR

Middle

Last Name

RUVINOV

Suffix

DDS

Business Name

SAMIR E RUVINOV DDS

Original Issue Date

10/02/1997

Effective Date

10/02/1997

Expiration Date

09/30/2000

City

EAST ALTON

State

Zip

62024

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005