LIONEL ALEXIS GIBSON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

ACTIVE

Business

Title

DMD

First Name

LIONEL

Middle

ALEXIS

Last Name

GIBSON

Business Name

LIONEL ALEXIS GIBSON DMD

Original Issue Date

08/02/2011

Effective Date

09/24/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/24/2024