CAROL A PAYNE NIFORATOS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

NOT RENEWED

Business

First Name

CAROL A PAYNE

Last Name

NIFORATOS

Business Name

CAROL A PAYNE NIFORATOS

Original Issue Date

09/09/1986

Effective Date

09/09/1986

Expiration Date

09/30/1998

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005