DIGNORA MARTINEZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

NOT RENEWED

Business

First Name

DIGNORA

Last Name

MARTINEZ

Business Name

DIGNORA MARTINEZ

Original Issue Date

02/01/1990

Effective Date

02/01/1990

Expiration Date

09/30/1992

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005