LISA E BLUMOFE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

BLUMOFE

Suffix

DDS

Business Name

LISA E BLUMOFE DDS

Original Issue Date

10/01/1998

Effective Date

01/24/2007

Expiration Date

09/30/2009

City

EAST ALTON

State

Zip

62024

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009