STEPHEN MICHAEL WILLENBORG DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****67

License Status

ACTIVE

Business

First Name

STEPHEN

Middle

MICHAEL

Last Name

WILLENBORG

Suffix

DMD

Business Name

STEPHEN MICHAEL WILLENBORG DMD

Original Issue Date

08/04/1998

Effective Date

07/11/2024

Expiration Date

09/30/2027

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

07/11/2024