KRISTOFFER JAN TUMILOWICZ 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

First Name

KRISTOFFER

Middle

JAN

Last Name

TUMILOWICZ

Suffix

DMD

Business Name

KRISTOFFER JAN TUMILOWICZ DMD

Original Issue Date

01/01/1998

Effective Date

11/04/2021

Expiration Date

09/30/2024

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025