KIM GIBBONS HAUG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****92

License Status

NOT RENEWED

Business

First Name

KIM

Middle

GIBBONS

Last Name

HAUG

Business Name

KIM GIBBONS HAUG

Original Issue Date

10/08/2013

Effective Date

10/24/2018

Expiration Date

01/31/2022

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022