JUSTIN M BONVALLET DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

ACTIVE

Business

First Name

JUSTIN

Middle

Last Name

BONVALLET

Suffix

DMD

Business Name

JUSTIN M BONVALLET DMD

Original Issue Date

10/16/2007

Effective Date

06/12/2024

Expiration Date

09/30/2027

City

BYRON

State

Zip

61010

County

OGLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/12/2024