STACEY DENISE ROBINSON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

ACTIVE

Business

Title

DMD

First Name

STACEY

Middle

DENISE

Last Name

ROBINSON

Business Name

STACEY DENISE ROBINSON DMD

Original Issue Date

07/11/2024

Effective Date

07/11/2024

Expiration Date

09/30/2027

City

BETHALTO

State

Zip

62010

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2024