JEFFREY DONALD LOBERG DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****95

License Status

NOT RENEWED

Business

Title

DMD

First Name

JEFFREY

Middle

DONALD

Last Name

LOBERG

Business Name

JEFFREY DONALD LOBERG DMD

Original Issue Date

08/21/2012

Effective Date

08/21/2012

Expiration Date

09/30/2015

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016