ALFRED DONALD URBANCKAS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****64

License Status

NOT RENEWED

Business

First Name

ALFRED DONALD

Last Name

URBANCKAS

Suffix

DDS

Business Name

ALFRED DONALD URBANCKAS DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2000

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/17/2005