DAVID HENRY CLEVEN DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

CANCELLED

Business

Title

DDS

First Name

DAVID

Middle

HENRY

Last Name

CLEVEN

Business Name

DAVID HENRY CLEVEN DDS

Original Issue Date

06/16/1976

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/04/2009