WINIFREDO S FABI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

First Name

WINIFREDO S

Last Name

FABI

Suffix

DMD

Business Name

WINIFREDO S FABI DMD

Original Issue Date

02/05/1996

Effective Date

02/05/1996

Expiration Date

09/30/1998

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005