MARTIN J CISNEROS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

ACTIVE

Business

First Name

MARTIN J

Last Name

CISNEROS

Suffix

DMD

Business Name

MARTIN J CISNEROS DMD

Original Issue Date

01/29/2008

Effective Date

09/04/2024

Expiration Date

09/30/2027

City

FREEBURG

State

Zip

62243

County

SAINT CLAIR

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

09/04/2024