JAMES PATRICK HEYNEN DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

CANCELLED

Business

First Name

JAMES

Middle

PATRICK

Last Name

HEYNEN

Suffix

DDS

Business Name

JAMES PATRICK HEYNEN DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2006

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2006