LARRY DEAN WILBORN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

First Name

LARRY DEAN

Last Name

WILBORN

Suffix

DDS

Business Name

LARRY DEAN WILBORN DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1990

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

10/13/2005