AMANDA ALEXIS GOODMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****66

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

ALEXIS

Last Name

GOODMAN

Business Name

AMANDA ALEXIS GOODMAN

Original Issue Date

11/10/2004

Effective Date

10/22/2021

Expiration Date

09/30/2024

City

TAMPA

State

Zip

33606

County

FLORIDA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025