THOMAS RYAN MOSS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014367

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

RYAN

Last Name

MOSS

Suffix

DDS

Business Name

THOMAS RYAN MOSS DDS

Original Issue Date

07/12/1972

Effective Date

09/28/2015

Expiration Date

09/30/2018

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/31/2018