KYLEA MARIE TIBBS-HNIZDO DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

ACTIVE

Business

First Name

KYLEA

Middle

MARIE

Last Name

TIBBS-HNIZDO

Suffix

DMD

Business Name

KYLEA MARIE TIBBS-HNIZDO DMD

Original Issue Date

12/05/2011

Effective Date

08/05/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62703

County

MENARD

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

08/05/2024