BARRETT GENE MOORE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001280

License Status

NOT RENEWED

Business

First Name

BARRETT

Middle

GENE

Last Name

MOORE

Business Name

BARRETT GENE MOORE

Original Issue Date

06/27/2001

Effective Date

06/27/2001

Expiration Date

06/30/2002

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005