ANNA M BONVALLET DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

ACTIVE

Business

First Name

ANNA

Middle

Last Name

BONVALLET

Suffix

DMD

Business Name

ANNA M BONVALLET DMD

Original Issue Date

10/16/2007

Effective Date

06/12/2024

Expiration Date

09/30/2027

City

PECATONICA

State

Zip

61063

County

OGLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/12/2024