GERALD RODGER MOON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013409

License Status

NOT RENEWED

Business

First Name

GERALD RODGER

Last Name

MOON

Suffix

DDS

Business Name

GERALD RODGER MOON DDS

Original Issue Date

07/16/1968

Effective Date

06/29/2012

Expiration Date

09/30/2015

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

02/08/2016