LAWRENCE EUGENE NEWQUIST Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

ACTIVE

Business

First Name

LAWRENCE EUGENE

Last Name

NEWQUIST

Business Name

LAWRENCE EUGENE NEWQUIST

Original Issue Date

10/05/1990

Effective Date

09/25/2024

Expiration Date

09/30/2027

City

GODFREY

State

Zip

62035

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2024