MARTIN J CISNEROS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****64

License Status

ACTIVE

Business

First Name

MARTIN J

Last Name

CISNEROS

Suffix

DMD

Business Name

MARTIN J CISNEROS DMD

Original Issue Date

09/27/2001

Effective Date

09/04/2024

Expiration Date

09/30/2027

City

COLUMBIA

State

Zip

62236

County

MONROE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/04/2024