ALISSA TERESE ANTHONY Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

ACTIVE

Business

First Name

ALISSA

Middle

TERESE

Last Name

ANTHONY

Business Name

ALISSA TERESE ANTHONY

Original Issue Date

08/21/2019

Effective Date

08/13/2024

Expiration Date

09/30/2027

City

LOVES PARK

State

Zip

61111

County

BOONE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2025