THOMAS WILLIAM EXNER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****44

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

WILLIAM

Last Name

EXNER

Business Name

THOMAS WILLIAM EXNER

Original Issue Date

06/29/2011

Effective Date

09/26/2012

Expiration Date

09/30/2015

City

PEWAUKEE

State

Zip

53072

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016