ALEXANDER VAN CIBOR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****19

License Status

NOT RENEWED

Business

First Name

ALEXANDER

Middle

VAN

Last Name

CIBOR

Business Name

ALEXANDER VAN CIBOR

Original Issue Date

06/15/2015

Effective Date

06/15/2015

Expiration Date

09/30/2018

City

MILWAUKEE

State

Zip

53212

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018