JUDITH A RUNNE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

First Name

JUDITH A

Last Name

RUNNE

Business Name

JUDITH A RUNNE

Original Issue Date

10/02/1987

Effective Date

10/02/1987

Expiration Date

09/30/1990

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005