CYRIL NICHOLAS KOCH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****42

License Status

NOT RENEWED

Business

First Name

CYRIL NICHOLAS

Last Name

KOCH

Business Name

CYRIL NICHOLAS KOCH

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/17/2005