MARION A IVANUCK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

NOT RENEWED

Business

First Name

MARION A

Last Name

IVANUCK

Suffix

DDS

Business Name

MARION A IVANUCK DDS

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

STEELEVILLE

State

Zip

62288

County

RANDOLPH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005