ALAN JOSEPH WICKENHAUSER DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****92

License Status

CANCELLED

Business

First Name

ALAN

Middle

JOSEPH

Last Name

WICKENHAUSER

Suffix

DMD

Business Name

ALAN JOSEPH WICKENHAUSER DMD

Original Issue Date

08/21/1998

Effective Date

08/21/1998

Expiration Date

09/30/2002

City

HIGHLAND

State

Zip

62249

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005