ALEXANDER FERDKOFF Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

NOT RENEWED

Business

First Name

ALEXANDER

Last Name

FERDKOFF

Business Name

ALEXANDER FERDKOFF

Original Issue Date

11/16/2010

Effective Date

09/06/2012

Expiration Date

09/30/2015

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016