ALLEN P KVIDERA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

ALLEN P

Last Name

KVIDERA

Business Name

ALLEN P KVIDERA

Original Issue Date

06/27/1983

Effective Date

06/27/1983

Expiration Date

09/30/1992

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005